Organization Active NPI

The Physical Therapy Center, Inc.

  • Orthopedic Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1902851884
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
THE PHYSICAL THERAPY CENTER, INC.
Practice address
12048 Tesson Ferry Rd
Saint Louis, MO 63128-1727
Phone
(314) 849-4455
Fax
(314) 849-2844
NPI assigned
May 23, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Lisa M. White
Title
Office Manager
Phone
(314) 849-4455

Specialties & licenses 1

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

Addresses

Primary practice location

12048 Tesson Ferry Rd
Saint Louis, MO 63128-1727

Mailing address

12048 Tesson Ferry Rd
Saint Louis, MO 63128-1727
Phone (314) 849-4455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060605000009 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830104314 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902851884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12048 TESSON FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281727",
            "telephone_number": "314-849-4455",
            "fax_number": "314-849-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12048 TESSON FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281727",
            "telephone_number": "314-849-4455",
            "fax_number": "314-849-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHYSICAL THERAPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-849-4455"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": null,
            "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.