NPIMap

Organization Active NPI

Axes Physical Therapy, LLC

  • Prosthetic/Orthotic Supplier
  • Wentzville, MO
National Provider Identifier
1720540313
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
AXES PHYSICAL THERAPY, LLC
Practice address
754 Luetkenhaus Blvd
Wentzville, MO 63385-3515
Phone
(636) 206-4225
NPI assigned
Apr 2, 2019
Last updated
Apr 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Teepe, MPT
Title
Partner
Phone
(314) 764-2230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

754 Luetkenhaus Blvd
Wentzville, MO 63385-3515

Mailing address

4273 Keaton Crossing Blvd
O Fallon, MO 63368-8220
Phone (636) 206-4225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190913000474 MO DME Supplier - Independently-Practicing Physical Therapist 3375840028 Practice locations: Wentzville, MO

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Axes Physical Therapy LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554163200000",
    "number": "1720540313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 KEATON CROSSING BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688220",
            "telephone_number": "636-206-4225",
            "fax_number": "636-422-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 LUETKENHAUS BLVD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853515",
            "telephone_number": "636-206-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXES PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-04-02",
        "status": "A",
        "authorized_official_last_name": "TEEPE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "314-764-2230",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.