Anita Farris Altemeyer, PT

Individual provider Active NPI Physical Therapist · St Clair, MO

NPI 1962664052 · NPPES record last updated Jun 1, 2010

Key facts

NPI
1962664052
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2007034421 (MO)
Practice address
214 Hartman Place
St Clair, MO 63077
Phone
(636) 629-9826
Fax
(636) 467-7094
NPI assigned
Jun 30, 2008
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Potential Therapy Services LLC (12 clinicians)

Practice addresses (Care Compare)

55 Nesbit Dr
Bonne Terre, MO 63628-1353
Phone (573) 358-9553

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200624001380 MO Practitioner - Physical Therapist in Private Practice 4587086350 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2007034421MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Potential Therapy Services LLC Current
since May 8, 2020
Accepting new patients

Locations

55 Nesbit Dr
Bonne Terre, MO 63628
Phone (573) 358-1700

2308 N Truman Blvd
Crystal City, MO 63019
Phone (636) 206-6070

60 Plaza Dr
Ste Genevieve, MO 63670
Phone (573) 608-5058

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2007034421 MO Yes

Addresses

Primary practice location

214 Hartman Place
St Clair, MO 63077

Mailing address

210 Eldon St
Cuba, MO 65453-1642

Other providers in St Clair, MO

All providers in St Clair, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.