Active NPI
Lauren L Mitchell, PTA
- Physical Therapy Assistant
- Creve Coeur, MO
National Provider Identifier
1942815840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2006030655
- Practice address
- 693 Decker LN
Creve Coeur, MO 63141-6766 - Phone
- (314) 997-4532
- NPI assigned
- Sep 9, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2006030655 | MO | Primary |
Addresses
Primary practice location
693 Decker LN
Creve Coeur, MO 63141-6766
Mailing address
1217 Wyncrest Dr
Ballwin, MO 63011-4411
Phone (141) 788-0010
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 |
|---|---|---|---|
| 2006030655 | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1942815840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 WYNCREST DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630114411",
"telephone_number": "141-788-0010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "693 DECKER LN",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631416766",
"telephone_number": "314-997-4532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "LAUREN",
"middle_name": "L",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-09",
"last_updated": "2020-09-09",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2006030655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
- Carol Ruth Mischnick, M.D.
- Missouri CVS Pharmacy, L.L.C.
- Missouri Imaging Affiliates LLC
- Missouri Pain Specialists, LLC
- Missouri Professional Staffing Service Home Health Inc
- Modern Vascular of St Louis LLC
- Kathleen M Monzyk, PT
- Rodney Rogers Moody
- Charles S Moore, MD
- Meghan M Moore, MSN, AGACNP, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.