Active NPI
Tara Joann Knoepp, DPT
- Physical Therapist
- Fenton, MO
National Provider Identifier
1992196992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2015003455
- Practice address
- 1011 Bowles Ave
Suite 150
Fenton, MO 63026-2395 - Phone
- (636) 343-9555
- Fax
- (636) 343-9556
- NPI assigned
- Feb 11, 2015
- 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 | 2015003455 | MO | Primary |
Addresses
Primary practice location
1011 Bowles Ave
Suite 150
Fenton, MO 63026-2395
Mailing address
2920 Bee Tree LN
Saint Louis, MO 63129-5308
Phone (314) 368-2865
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015003455 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Select Rehab St Louis LLC | 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.
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1992196992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 BEE TREE LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631295308",
"telephone_number": "314-368-2865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 BOWLES AVE",
"address_2": "SUITE 150",
"city": "FENTON",
"state": "MO",
"postal_code": "630262395",
"telephone_number": "636-343-9555",
"fax_number": "636-343-9556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOEPP",
"first_name": "TARA",
"middle_name": "JOANN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-11",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2015003455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.