Active NPI
Derek Curtis, PTA
- Physical Disabilities Residential Treatment Facility
- Mount Vernon, MO
National Provider Identifier
1861834699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Disabilities Residential Treatment Facility
- License
- 2013025663
- Practice address
- 1600 S Hickory St
Mount Vernon, MO 65712-2045 - Phone
- (417) 466-7103
- Fax
- (417) 466-4040
- NPI assigned
- Jul 22, 2013
- Last updated
- Jul 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 Disabilities Residential Treatment Facility | 320700000X | 2013025663 | MO | Primary |
Addresses
Primary practice location
1600 S Hickory St
Mount Vernon, MO 65712-2045
Mailing address
1600 S Hickory St
Mount Vernon, MO 65712-2045
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013025663 | MO | MD | Physical Disabilities Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374451200000",
"number": "1861834699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 S HICKORY ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657122045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 S HICKORY ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657122045",
"telephone_number": "417-466-7103",
"fax_number": "417-466-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CURTIS",
"first_name": "DEREK",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-22",
"last_updated": "2013-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": "MO",
"license": "2013025663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, MO
- Brittney Conway, PHARMD
- Cox-Monett Hospital Inc (Coxhealth Center Mt.Vernon)
- Monica Whitney Cunningham, DPT
- Curators of the University of Missouri (Missouri Rehabilitation Center)
- Curators University of Mo (Dba Missouri Rehabilitation Center-Physicians Group)
- Sabrina A Davis, OTR
- Elizabeth Evalyn Dean, D.O.
- Robert J Dieckhoff
- Bethany Laurian Douglas, MSN FNP-C
- Michael Newman Douglas, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.