Living Active Rehab & Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LIVING ACTIVE REHAB & WELLNESS

Practice address

1401 Gettysburg LNDG
Saint Charles, MO 63303-6104

Phone

(636) 443-9910

NPI assigned

Aug 4, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Bray, PT, DPT

Title

Owner, Ceo

Phone

(636) 443-9910

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1962012906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GETTYSBURG LNDG",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036104",
            "telephone_number": "636-443-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GETTYSBURG LNDG",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036104",
            "telephone_number": "636-443-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING ACTIVE REHAB & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "636-443-9910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan E Litteken, DDS
• Little Hills Healthcare, LLC
• Jaime Jean Little, MA CCC-SLP
• Dianna Liu, M.D.
• Live Well Chiropractic LLC
• Living With Purpose of Missouri, Inc.
• Steven B Livingstone, D.O.
• Pete Anthony Lo Grasso
• Emily Bernadine Loaiza Moore, L.P.C.
• Megan Jennifer Lock, DC

• All providers in Saint Charles, MO
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.

Verify at the official NPI Registry.