PROREHAB PC (NPI# 1114538097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114538097 |
| Entity Type | Organization |
| Organization Name | PROREHAB PC |
| Practice Address |
3156 Telegraph Rd Saint Louis MO 63125-5500 |
| Mailing Address |
600 Oakmont Ln Ste 600c Westmont IL 60559-5548 |
| Practice Telephone | 3148948616 |
| Practice Fax Number | 3148948633 |
| Mailing Telephone | 6305756200 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | JUANA GRANADOS (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 6305751980 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROREHAB PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ATHLETICO PHYSICAL THERAPY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629691639 | Prorehab PC | Physical Therapist | 603 S Bishop Ave Ste B, Rolla, MO 65401-4320 | 2020-05-26 |
| 1972148179 | Prorehab PC | Occupational Therapist | 301 S Maple St, Eldon, MO 65026-1854 | 2019-11-12 |
| 1992295570 | Prorehab PC | Physical Therapist | 709 W. Marion Street, Marion, IL 62959-2439 | 2018-05-18 |
| 1467949040 | Prorehab PC | Physical Therapist | 2136 William St Ste 115, Cape Girardeau, MO 63703-5830 | 2018-04-18 |
| 1053820175 | Prorehab PC | Clinic/Center | 11525 Olde Cabin Rd Ste 1, Saint Louis, MO 63141-7146 | 2017-09-20 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1043661465 | Prorehab PC | Physical Therapist | 6309 Ronald Reagan Dr, Lake St Louis, MO 63367-2681 | 2016-06-27 |
| 1316393366 | Prorehab PC | Physical Therapist | 3940 Green Mount Crossing Dr, Shiloh, IL 62269-7289 | 2016-05-09 |
| 1760435440 | Prorehab PC | Clinic/Center | 15884 Manchester Rd, Ellisville, MO 63011-2208 | 2006-05-17 |
| 1932700358 | Prorehab PC | Clinic/Center | 600 Oakmont Ln Ste 600c, Westmont, IL 60559-5548 | 2020-11-03 |
| Street Address |
3156 TELEGRAPH RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63125-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396990 | Linda Marie Monken | Technician | 3792 Southern Manor, St. Louis, MO 63125 | 2019-09-25 |
| 1194373688 | Angel Angelette Rochelle Ellington | Technician | Va St Louis Spinal Cord Injury Unit, 1 Jefferson Barracks Drive 128/jb, St Louis, MO 63125 | 2019-08-28 |
| 1760940209 | Lea-ed Inc | Community Based Residential Treatment Facility, Mental Illness | 30 Sherman Road, Lemay, MO 63125 | 2019-03-04 |
| 1861957185 | Mary M Ross | Occupational Therapist | Sherbrooke Village, 4005 Ripa Ave, St. Louis, MO 63125 | 2019-02-01 |
| 1013400977 | Anne Henry Francis | Dietitian, Registered | Va St. Louis Health Care System, 1 Jefferson Barracks Drive, St. Louis, MO 63125 | 2018-06-14 |
| 1922458660 | Rebecca Mae Waugh | Skilled Nursing Facility | 1001 Holy Grail Ct, Saint Louis, MO 63125 | 2016-06-14 |
| 1942661814 | Dsk Works LLC | Chiropractor | 3193 Lemay Ferry Rd., Saint Louis, MO 63125 | 2016-03-18 |
| 1467717678 | Despine Louise Coulis | Pediatrics | 7545 S Lindbergh Blvd Ste 220, Saint Louis, MO 63125 | 2012-07-13 |
| 1184914194 | Allison Celeste Cassidy | Pharmacist | 3901 Lemay Ferry Road, Saint Louis, MO 63125 | 2011-04-11 |
| 1093049694 | Lauren C Mensie | Psychologist | 1 Jefferson Barracks Dr., 116b/jb St. Louis Va Medical Center, St. Louis, MO 63125 | 2009-09-29 |
| Find all providers in zip 63125 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275014953 | Arch Pediatrics LLC | Clinic/Center | 3844 S Lindbergh Blvd Ste 216, Saint Louis, MO 63127-1369 | 2018-08-22 |
| 1174015515 | Washington University Physicians In Illinois, Inc | Clinic/Center | 4511 Forest Park Ave, Saint Louis, MO 63108-2138 | 2018-06-01 |
| 1073022000 | Fairview Heights Medical Group Sc | Clinic/Center | 670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573 | 2017-09-21 |
| 1174830640 | Washington University School of Medicine | Clinic/Center | 4921 Parkview Pl Lowr Level, Center for Advanced Medicine, Saint Louis, MO 63110-1032 | 2010-09-07 |
| 1013542877 | Washington University | Clinic/Center | 4921 Parkview Pl Ste 5a, Saint Louis, MO 63110-1032 | 2020-03-11 |
| 1760946156 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2019-01-30 |
| 1003387689 | Victus Physician Services, LLC | Clinic/Center | 12345 West Bend Drive, Suite 201, Saint Louis, MO 63128 | 2018-12-08 |
| 1356822993 | Washington University Physicians In Illinois, Inc | Clinic/Center | 660 S Euclid Ave, Saint Louis, MO 63110-1010 | 2018-08-22 |
| 1972091825 | Wuca Southwest Pediatrics LLC | Clinic/Center | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2018-04-26 |
| 1669995403 | Washington University | Clinic/Center | 11125 Dunn Rd Ste 100, Saint Louis, MO 63136-6132 | 2017-07-24 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63125 |
Please comment or provide details below to improve the information on PROREHAB PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.