Individual provider Active NPI

Meghan Anne Gravlin, DPT

  • Physical Therapist
  • Florissant, MO
National Provider Identifier
1780972471
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
MO2011021977 Issued in MO
Practice address
3501 Dunn Rd
Suite 108
Florissant, MO 63033-6762
Phone
(314) 209-7700
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MO2011021977 MO Primary

Addresses

Primary practice location

3501 Dunn Rd
Suite 108
Florissant, MO 63033-6762

Mailing address

3501 Dunn Rd
Suite 108
Florissant, MO 63033-6762
Phone (314) 209-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000530 MO Practitioner - Physical Therapist in Private Practice 1557799855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Missouri, Columbia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axes Physical Therapy LLCGroup PAC ID 3375840028, 112 clinicians

Practice addresses (Care Compare)

7483 Mexico Rd
Saint Peters, MO 63376-1304
Phone (636) 206-3654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MO2011021977MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Feb 2, 2020 Accepting new patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Feb 2, 2020 Accepting new patients

Locations

1155 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

7483 Mexico Rd
Saint Peters, MO 63376
Phone (636) 206-3654

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

718 Luetkenhaus Blvd
Wentzville, MO 63385
Phone (636) 445-5001

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1780972471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 DUNN RD",
            "address_2": "SUITE 108",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336762",
            "telephone_number": "314-209-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 DUNN RD",
            "address_2": "SUITE 108",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336762",
            "telephone_number": "314-209-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVLIN",
        "first_name": "MEGHAN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "MO2011021977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.