Individual provider Active NPI

Shawn Heck, PT, CHT

  • Physical Therapist
  • Warrenton, MO
National Provider Identifier
1902857535
Registry record updated Aug 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
119324 Issued in MO
Practice address
605 E Booneslick Rd
Suite 3
Warrenton, MO 63383-2127
Phone
(636) 456-6350
Fax
(636) 456-6084
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 119324 MO Primary

Addresses

Primary practice location

605 E Booneslick Rd
Suite 3
Warrenton, MO 63383-2127

Mailing address

2454 W Clay St
Saint Charles, MO 63301-2548
Phone (636) 916-4625

Other identifiers 1

IdentifierTypeStateIssuer
P00399992OtherMORAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000111 MO Practitioner - Physical Therapist in Private Practice 4587612544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Missouri, Columbia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axes Physical Therapy LLCGroup PAC ID 3375840028, 112 clinicians

Practice addresses (Care Compare)

7483 Mexico Rd
Saint Peters, MO 63376-1304
Phone (636) 206-3654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119324MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince May 19, 2021 Accepting new patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince May 19, 2021 Accepting new patients
Babar Enterprises LLC Physical Therapist Past Accepting new patients
Rueschhoff Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

1155 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

7483 Mexico Rd
Saint Peters, MO 63376
Phone (636) 206-3654

5200 Executive Centre Pkwy
Ste 200
Saint Peters, MO 63376
Phone (636) 255-8750

21 Silo Dr
Union, MO 63084
Phone (636) 649-4131

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

Organizations & group practices 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345248000000",
    "number": "1902857535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 W CLAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012548",
            "telephone_number": "636-916-4625",
            "fax_number": "636-916-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E BOONESLICK RD",
            "address_2": "SUITE 3",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633832127",
            "telephone_number": "636-456-6350",
            "fax_number": "636-456-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECK",
        "first_name": "SHAWN",
        "credential": "PT,  CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "119324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00399992",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.