Active NPI
Alyssa Jane Scoville, DPT
- Physical Therapist
- Bridgeton, MO
National Provider Identifier
1811461577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2018039733
- Practice address
- 12380 De Paul Dr
Bridgeton, MO 63044-2511 - Phone
- (314) 447-9710
- NPI assigned
- Jan 16, 2019
- Last updated
- Jan 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2018039733 | MO | Primary |
Addresses
Primary practice location
12380 De Paul Dr
Bridgeton, MO 63044-2511
Mailing address
8912 Moritz Ave
Saint Louis, MO 63144-1733
Phone (314) 607-0068
Other names 1
- Alyssa Jane Surgener
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7200 Manchester Rd
Saint Louis, MO 63143-2403
Phone (618) 540-8129
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Select Rehab St Louis LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Inspire Physical Therapy and Wellness
- Physical Therapist
- Saint Louis, MO
- NPI 1952131153
-
- Physical Medicine & Rehabilitation Physician
- Richmond Heights, MO
- NPI 1558403261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1811461577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8912 MORITZ AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631441733",
"telephone_number": "314-607-0068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12380 DE PAUL DR",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442511",
"telephone_number": "314-447-9710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOVILLE",
"first_name": "ALYSSA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2018039733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALYSSA",
"last_name": "SURGENER",
"middle_name": "JANE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.