Active NPI
Ryan R Pretz, PT
- Physical Therapist
- Poplar Bluff, MO
National Provider Identifier
1962465658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2004007960
- Practice address
- 3999 Highway PP Ste 2
Poplar Bluff, MO 63901-9130 - Phone
- (573) 712-2280
- NPI assigned
- Apr 11, 2006
- 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 | 2004007960 | MO | Primary |
Addresses
Primary practice location
3999 Highway PP Ste 2
Poplar Bluff, MO 63901-9130
Mailing address
PO Box 411277
Creve Coeur, MO 63141
Phone (573) 712-2280
Other practice location 1
2981 Kanell Blvd
Poplar Bluff, MO 63901
Phone (573) 712-2280
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 489274001 | Medicaid | MO | |
| P00607881 | Other | MO | PALMETTO GBA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ryanpretz@mhccaremail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Rehabilitation, LLC | Physical Therapist | Current | Accepting new patients |
| Select Physical Therapy Holdings, Inc. | Current | Accepting new patients | |
| Prorehab PC | Physical Therapist | Past | Accepting new patients |
| Ozark Physical Therapy, LLP | Past | Accepting new patients |
Locations
2981 Kanell Blvd
Poplar Bluff, MO 63901
Phone (573) 712-2280
3999 Highway PP
Ste 2
Poplar Bluff, MO 63901
Phone (573) 712-2280
Organizations & group practices 4
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
- Poplar Bluff, MO
- NPI 1588848618
Physical Therapist
-
- Physical Therapy Clinic/Center
- Poplar Bluff, MO
- NPI 1336869338
-
- Durable Medical Equipment & Medical Supplies
- Poplar Bluff, MO
- NPI 1942272836
-
- Physical Therapist
- Oak Brook, IL
- NPI 1538119409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1962465658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 411277",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "63141",
"telephone_number": "573-712-2280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3999 HIGHWAY PP STE 2",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639019130",
"telephone_number": "573-712-2280"
}
],
"practiceLocations": [
{
"address_1": "2981 Kanell Blvd",
"address_purpose": "LOCATION",
"city": "Poplar Bluff",
"state": "MO",
"postal_code": "63901",
"country_code": "US",
"telephone_number": "573-712-2280",
"fax_number": "573-778-9589",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRETZ",
"first_name": "RYAN",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2004007960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "489274001",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA",
"identifier": "P00607881",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ryanpretz@mhccaremail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3999 Highway Pp Ste 2",
"city": "Poplar Bluff",
"state": "MO",
"country_code": "US",
"postal_code": "639019130",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.