NPIMap

Organization Active NPI

Prorehab PC

  • Physical Therapy Clinic/Center
  • Ellisville, MO
National Provider Identifier
1760435440
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PROREHAB PC
Practice address
15884 Manchester Rd
Ellisville, MO 63011-2208
Phone
(636) 391-5400
Fax
(636) 394-9674
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dorene Mack
Title
A/R Manager
Phone
(314) 238-2209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

15884 Manchester Rd
Ellisville, MO 63011-2208

Mailing address

13537 Barrett Parkway Dr
Suite 105
Ballwin, MO 63021-5899
Phone (314) 821-9126

National Provider Directory

National Provider Directory
Tax ID family
Prorehab PC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

13537 Barrett Parkway Dr
Ste 105
Ballwin, MO 63021
Phone (314) 821-9126

15884 Manchester Rd
Ellisville, MO 63011
Phone (636) 220-9335

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760435440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13537 BARRETT PARKWAY DR",
            "address_2": "SUITE 105",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215899",
            "telephone_number": "314-821-9126",
            "fax_number": "314-821-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15884 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112208",
            "telephone_number": "636-391-5400",
            "fax_number": "636-394-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROREHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DORENE",
        "authorized_official_title_or_position": "A/R MANAGER",
        "authorized_official_telephone_number": "314-238-2209"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.