Active NPI
Ryan Jacob Bandermann, MPT
- Physical Therapist
- Cape Girardeau, MO
National Provider Identifier
1952596777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2007023010
- Practice address
- 211 Saint Francis Dr
Cape Girardeau, MO 63703-5049 - Phone
- (573) 331-5806
- Fax
- (573) 331-5028
- NPI assigned
- Sep 14, 2007
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | 2007023010 | MO | Primary |
Addresses
Primary practice location
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Mailing address
PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007023010 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1952596777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 801143",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641801143",
"telephone_number": "573-331-5583",
"fax_number": "573-331-5079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 SAINT FRANCIS DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637035049",
"telephone_number": "573-331-5806",
"fax_number": "573-331-5028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDERMANN",
"first_name": "RYAN",
"middle_name": "JACOB",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-14",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2007023010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.