Sports and Physical Therapy Center

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2001005492 Issued in MO

Legal business name

SPORTS AND PHYSICAL THERAPY CENTER

Practice address

322 N Central Ave
Eureka, MO 63025-1826

Phone

(636) 938-4065

Fax

(636) 938-4067

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Sean C Quinn, PT

Title

President

Phone

(636) 938-4065

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• SPTC Doing business as

Locations

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1770514879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N CENTRAL AVE",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251826",
            "telephone_number": "636-938-4065",
            "fax_number": "636-938-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N CENTRAL AVE",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251826",
            "telephone_number": "636-938-4065",
            "fax_number": "636-938-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND PHYSICAL THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-938-4065",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2001005492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "11299",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00158791",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "683038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP ADVANTRA CMR",
            "identifier": "227075",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400737",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "193453",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "610149300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7889614",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.