Pro Fitness & Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRO FITNESS & REHAB LLC

Practice address

3021 Highway a Ste 102
Washington, MO 63090-5498

Phone

(636) 234-5211

NPI assigned

Jan 20, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Noelker, PTNPI 1811172414

Title

Managing Member/Owner

Phone

(636) 221-5188

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Faye Noelker, PT

  • Physical Therapist
  • Washington, MO
  • NPI 1811172414
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1730831769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 STONECREST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 HIGHWAY A STE 102",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905498",
            "telephone_number": "636-234-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO FITNESS & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "NOELKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "636-221-5188",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Pohl
• Joseph L Polizzi, M.D.
• Jessica Nicole Pollihan, M.S. CCC- SLP
• Jillian Poretti, RD LD
• Gregory A. Potts, M.D.
• Professional Counseling Connections
• Prorehab, PC (Athletico Physical Therapy)
• Provider Plus Inc
• Quest Diagnostics Clinical Laboratories Inc
• Rashid Mahmood Qureshi, MD

• Physical Therapist in Washington, MO
• Providers in Washington, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.