Active NPI
Scott Wendell Rose
- Physical Therapist
- Saint Louis, MO
National Provider Identifier
1821142019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01843
- Practice address
- 12855 N 40 Dr
Saint Louis, MO 63141-8657 - Phone
- (314) 469-0760
- Fax
- (314) 469-0034
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- 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 | 01843 | MO | Primary |
Addresses
Primary practice location
12855 N 40 Dr
Saint Louis, MO 63141-8657
Mailing address
25 Brook Mill LN
Chesterfield, MO 63017-8303
Phone (314) 576-9699
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01843 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1821142019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 BROOK MILL LN",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630178303",
"telephone_number": "314-576-9699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12855 N 40 DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418657",
"telephone_number": "314-469-0760",
"fax_number": "314-469-0034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "SCOTT",
"middle_name": "WENDELL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "01843",
"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 Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.