Individual provider Active NPI

Corey Beth Woldenberg, DPT

  • Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1811320682
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2022046622 Issued in MO
Practice address
4921 Parkview PL
Dept Physical Therapy, Ste 14B
Saint Louis, MO 63110-1032
Phone
(314) 286-1940
Fax
(314) 286-1473
NPI assigned
Aug 15, 2013
Reactivated
May 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 2022046622 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Dept Physical Therapy, Ste 14B
Saint Louis, MO 63110-1032

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 286-1940

Other identifiers 1

IdentifierTypeStateIssuer
480124090MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230609002772 MO Practitioner - Physical Therapist in Private Practice 5597122309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

4444 Forest Park Ave
Saint Louis, MO 63108-2212

4921 Parkview PL
Saint Louis, MO 63110-1032
Phone (314) 286-1940

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jun 1, 2023 Accepting new patients
Washington University Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Rehabclinics SPT, Inc. Past Accepting new patients
Reconstructive Orthopaedic Associates II LLC Past Accepting new patients

Locations

4444 Forest Park Ave
#8502
Saint Louis, MO 63108
Phone (314) 286-1430

4444 Forest Park Ave
Ste 1210
Saint Louis, MO 63108

660 S Euclid Ave
Saint Louis, MO 63110

4444 Forest Park Ave
Ste 1101
Saint Louis, MO 63108
Phone (314) 286-1440

4921 Parkview Pl
Ste 14B
Saint Louis, MO 63110
Phone (314) 454-5580

Organizations & group practices 4

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": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1811320682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-286-1940",
            "fax_number": "314-286-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DEPT PHYSICAL THERAPY, STE 14B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-286-1940",
            "fax_number": "314-286-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDENBERG",
        "first_name": "COREY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2025-04-17",
        "certification_date": "2023-05-19",
        "deactivation_date": "2019-06-28",
        "reactivation_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2022046622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480124090",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Dept Physical Therapy, Ste 14B",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 17, 2025; 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.