Individual provider Active NPI

Lori L Gaskell, PT

  • Pediatric Physical Therapist
  • Saint Louis, MO
National Provider Identifier
1912032863
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
108122 Issued in MO
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

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
487504706MedicaidMO

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

LicenseStateTypeSpecialty
108122MOMDPediatric 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.

Verify at the official NPI Registry.