NPIMap

Organization Active NPI

Sports Medicine and Training Center

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1790873883
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPORTS MEDICINE AND TRAINING CENTER
Practice address
119 Watson Plaza
St. Louis, MO 63126-1962
Phone
(314) 961-3787
Fax
(314) 961-0974
NPI assigned
Oct 11, 2006
Last updated
Sep 12, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
SPORTS MEDICINE AND TRAINING CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
R. Scott Van Nest, P.T.
Title
Owner
Phone
(314) 961-3787

Specialties & licenses 1

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

Addresses

Primary practice location

119 Watson Plaza
St. Louis, MO 63126-1962

Mailing address

119 Watson Plaza
St. Louis, MO 63126-1962
Phone (314) 961-3787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060327000222 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6305854761 Receives reassigned benefits from 3 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory
Part of
Sports Med Training Center

Locations

12691 Conway Rd
Creve Coeur, MO 63141
Phone (314) 434-0400

119 Watson Plz
Saint Louis, MO 63126
Phone (314) 961-3787

8235 Clayton Rd
Saint Louis, MO 63117
Phone (314) 530-5990

20 Allen Ave
Ste 300
Webster Groves, MO 63119
Phone (314) 961-3787

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1790873883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WATSON PLAZA",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631261962",
            "telephone_number": "314-961-3787",
            "fax_number": "314-961-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WATSON PLAZA",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631261962",
            "telephone_number": "314-961-3787",
            "fax_number": "314-961-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE AND TRAINING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPORTS MEDICINE AND TRAINING CENTER",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "VAN NEST",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-961-3787",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.