Active NPI
Thomas Rex Whitworth, PTA
- Physical Therapy Assistant
- Saint Louis, MO
National Provider Identifier
1952778607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2015024499
- Practice address
- 11960 Westline Industrial Dr
#201
Saint Louis, MO 63146-3209 - Phone
- (314) 819-0480
- NPI assigned
- Aug 28, 2015
- 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 Therapy Assistant | 225200000X | 2015024499 | MO | Primary |
Addresses
Primary practice location
11960 Westline Industrial Dr
#201
Saint Louis, MO 63146-3209
Mailing address
5421 Pernod Ave
Saint Louis, MO 63139-1536
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 |
|---|---|---|---|
| 2015024499 | MO | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supplemental Health Care | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Saint Louis, MO
- NPI 1700172400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440720000000",
"number": "1952778607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5421 PERNOD AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631391536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11960 WESTLINE INDUSTRIAL DR",
"address_2": "#201",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631463209",
"telephone_number": "314-819-0480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITWORTH",
"first_name": "THOMAS",
"middle_name": "REX",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-28",
"last_updated": "2015-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2015024499",
"primary": true
}
],
"identifiers": [],
"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 Aug 28, 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.