Active NPI
Ma. Teresa Sison Enciso, PT
- Physical Therapist
- Waynesville, MO
National Provider Identifier
1871657916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- RO911
- Practice address
- 124 Ichord Ave
Waynesville, MO 65583-5406 - Phone
- (573) 774-3684
- NPI assigned
- Dec 21, 2006
- 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 | RO911 | MO | Primary |
Addresses
Primary practice location
124 Ichord Ave
Waynesville, MO 65583-5406
Mailing address
1207 Stratford LN
Rolla, MO 65401-3838
Phone (573) 341-2827
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 |
|---|---|---|---|
| RO911 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1871657916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 STRATFORD LN",
"city": "ROLLA",
"state": "MO",
"postal_code": "654013838",
"telephone_number": "573-341-2827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 ICHORD AVE",
"city": "WAYNESVILLE",
"state": "MO",
"postal_code": "655835406",
"telephone_number": "573-774-3684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENCISO",
"first_name": "MA. TERESA",
"middle_name": "SISON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "RO911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waynesville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.