Individual provider Active NPI

Mary Beth George, PTA

  • Specialist
  • Chesterfield, MO
National Provider Identifier
1780908426
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
117284 Issued in MO
Practice address
1176 Town and Country Commons
Chesterfield, MO 63017-8200
Phone
(636) 207-2200
Fax
(636) 207-2201
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 117284 MO Primary

Addresses

Primary practice location

1176 Town and Country Commons
Chesterfield, MO 63017-8200

Mailing address

1176 Town and Country Commons
Chesterfield, MO 63017-8200
Phone (636) 207-2200

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

LicenseStateTypeSpecialty
117284MOMDSpecialist

Interoperability endpoints

  • Direct secure messaging: mgeorge101521@directc.mercy.net

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1780908426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 TOWN AND COUNTRY COMMONS",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178200",
            "telephone_number": "636-207-2200",
            "fax_number": "636-207-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 TOWN AND COUNTRY COMMONS",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178200",
            "telephone_number": "636-207-2200",
            "fax_number": "636-207-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "117284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.