NPIMap

Individual provider Active NPI

Julie A Drafall, PT

  • Pediatric Physical Therapist
  • St. Louis, MO
National Provider Identifier
1821189184
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2005025971 Issued in MO
Practice address
1177 N. Warson Rd
St. Louis, MO 63132
Phone
(314) 569-2211
Fax
(314) 569-3656
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2005025971 MO
Pediatric Physical Therapist 2251P0200X 2005025971 MO Primary

Addresses

Primary practice location

1177 N. Warson Rd
St. Louis, MO 63132

Mailing address

1177 N. Warson Rd
St. Louis, MO 63132
Phone (314) 569-2211

Other identifiers 1

IdentifierTypeStateIssuer
487588402MedicaidMO

Other names 1

  • Julie Ann Suellentrop Former name

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

LicenseStateTypeSpecialty
2005025971MOMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South St. Louis Rehabilitation Institute, Inc. PastSince Oct 1, 2010 Accepting new patients
St. Louis Arc Past Accepting new patients
St. Louis Arc Inc Pediatrics Past Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1821189184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 N. WARSON RD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63132",
            "telephone_number": "314-569-2211",
            "fax_number": "314-569-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 N. WARSON RD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63132",
            "telephone_number": "314-569-2211",
            "fax_number": "314-569-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAFALL",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2005025971",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MO",
            "license": "2005025971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487588402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "SUELLENTROP",
            "middle_name": "ANN",
            "credential": "LPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.