Active NPI
Stephanie Joyce Wolterstorff, DPT
- Physical Therapist
- Lake Saint Louis, MO
National Provider Identifier
1962926931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2017027027
- Practice address
- 2 Harbor Bend CT
Lake Saint Louis, MO 63367-1478 - Phone
- (636) 695-2070
- NPI assigned
- Aug 1, 2017
- Sex
- Female
- 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 | 2017027027 | MO | Primary |
Addresses
Primary practice location
2 Harbor Bend CT
Lake Saint Louis, MO 63367-1478
Mailing address
7705 Ravensridge Rd
Saint Louis, MO 63119-5505
Phone (406) 480-9300
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 |
|---|---|---|---|
| 2017027027 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501545600000",
"number": "1962926931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7705 RAVENSRIDGE RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631195505",
"telephone_number": "406-480-9300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 HARBOR BEND CT",
"city": "LAKE SAINT LOUIS",
"state": "MO",
"postal_code": "633671478",
"telephone_number": "636-695-2070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLTERSTORFF",
"first_name": "STEPHANIE",
"middle_name": "JOYCE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-01",
"last_updated": "2017-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2017027027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake 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 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.