Mary Roche, PT, CHT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

104831 Issued in MO

Practice address

4800 Mexico Rd
Ste104
Saint Peters, MO 63376-1666

Phone

(636) 939-9540

Fax

(636) 939-9886

NPI assigned

Aug 29, 2006

Last updated

Aug 24, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Babar Enterprises LLC

  dba Excel Sports & Physical Therapy

  • Physical Therapist
  • Creve Coeur, MO
  • NPI 1033178827
  NPD (past)
• Babar Enterprises LLC

  dba Excel Sports and Physical Therapy

  • Physical Therapist
  • Warrenton, MO
  • NPI 1548425002
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1740399476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 W CLAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012548",
            "telephone_number": "636-916-4625",
            "fax_number": "636-916-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MEXICO RD",
            "address_2": "STE104",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761666",
            "telephone_number": "636-939-9540",
            "fax_number": "636-939-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "MARY",
        "credential": "PT, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "104831",
            "primary": true
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "MO",
            "license": "1041100253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00602661",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert T Rizzuti, D.M.D.
• Margaret Ann Roberts, LCSW
• Nan Roberts, RN, AP/MHCNS
• Danielle Elizabeth Robertson
• Danielle Marie Robinson, PA-C
• Talia M Roche, PHARMD
• Deidra Deann Rodriguez
• Kenneth Rodriguez, LMT
• Ubaldo R Rodriguez, MD
• Renee Rogers

• Physical Therapist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.