Active NPI
Robert Warren Baronovic, PT
- Physical Therapist
- Lake St Louis, MO
National Provider Identifier
1740010180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- R0710
- Practice address
- 100 Medical PLZ
Lake St Louis, MO 63367-1366 - Phone
- (636) 625-5000
- NPI assigned
- Aug 1, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | R0710 | MO | Primary |
Addresses
Primary practice location
100 Medical PLZ
Lake St Louis, MO 63367-1366
Mailing address
905 Indian Hills Dr
Saint Charles, MO 63301-0619
Phone (363) 578-4620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0710 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1740010180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 INDIAN HILLS DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633010619",
"telephone_number": "363-578-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEDICAL PLZ",
"city": "LAKE ST LOUIS",
"state": "MO",
"postal_code": "633671366",
"telephone_number": "636-625-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARONOVIC",
"first_name": "ROBERT",
"middle_name": "WARREN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-01",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "R0710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake St Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.