Active NPI
Lori L Gaskell, PT
- Pediatric Physical Therapist
- Saint Louis, MO
National Provider Identifier
1912032863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 108122
- Practice address
- 12430 Tesson Ferry Rd Ste 352
Saint Louis, MO 63128-2702 - Phone
- (866) 495-5437
- Fax
- (866) 495-2445
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 108122 | MO | Primary |
Addresses
Primary practice location
12430 Tesson Ferry Rd Ste 352
Saint Louis, MO 63128-2702
Mailing address
8715 Silver Rd
Otterville, MO 65348-2205
Phone (660) 366-4623
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 487504706 | Medicaid | MO |
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 |
|---|---|---|---|
| 108122 | MO | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1912032863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8715 SILVER RD",
"city": "OTTERVILLE",
"state": "MO",
"postal_code": "653482205",
"telephone_number": "660-366-4623",
"fax_number": "866-495-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12430 TESSON FERRY RD STE 352",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631282702",
"telephone_number": "866-495-5437",
"fax_number": "866-495-2445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASKELL",
"first_name": "LORI",
"middle_name": "L",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "MO",
"license": "108122",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "487504706",
"state": "MO"
}
],
"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 Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.