Adrienne Ebersole, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2020016709 Issued in MO

Practice address

514 S Main St
O Fallon, MO 63366-2535

Phone

(636) 730-1188

NPI assigned

Jul 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atr Ryan LLCGroup PAC ID 5294965943, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Atr Ryan LLC

  dba Advanced Training and Rehab

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1700215803
  Medicare reassignment Care Compare group NPD
• Advanced Training and Rehab LLC

  • Physical Therapist
  • Chesterfield, MO
  • NPI 1174576045
  NPD (past)

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1750909784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14515 N OUTER 40 RD STE 110",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175746",
            "telephone_number": "573-220-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S MAIN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662535",
            "telephone_number": "636-730-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "ADRIENNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2020016709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "2020016709",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley M Dyer
• Christy Marie Dyer, FNP-BC
• Dynamic Life Chiropractic, LLC (Lake St. Louis Chiropractic)
• E.D. Johnnie LLC
• Elizabeth Eaton, MSW, LCSW
• Tina Lynn Ebert, CCC-SLP
• Gloria Michelle Paul Edacheril, NP
• Dennis A Edson, RPH
• Edward M. Logan, DDS, LC
• Sarah Marie Effler, PT, MPT

• Physical Therapist in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.