SPORTS MEDICINE & TRAINING CENTER, LLC (NPI# 1255508628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255508628 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE & TRAINING CENTER, LLC |
| Practice Address |
12691 Conway Rd Creve Coeur MO 63141-8633 |
| Mailing Address |
119 Watson Plaza St. Louis MO 63129-1962 |
| Practice Telephone | 3144340400 |
| Practice Fax Number | 3144340402 |
| Mailing Telephone | 3149613787 |
| Mailing Fax Number | 3149610974 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2012-09-13 |
| Authorized Official Name | ROLAND SCOTT VAN NEST (OWNER) |
| Authorized Official Telephone | 3149613787 |
| Authorized Official Credential | PT |
| Is Organization Subpart | Y |
| Parent Organization Name | SPORTS MEDICINE & TRAINING CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| Street Address |
12691 CONWAY RD |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-8633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699928473 | Kristen Mary Soens | Physical Therapist | 12691 Conway Rd, Creve Coeur, MO 63141-8633 | 2008-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679947774 | Elite Physical Therapy of Creve Coeur LLC | Clinic/Center | 12788 Olive Blvd, Creve Coeur, MO 63141-6211 | 2015-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265073845 | Arnold Physical Therapy & Sports Medicine LLC | Clinic/Center | 9594 Manchester Rd, Saint Louis, MO 63119-1313 | 2019-10-04 |
| 1790326916 | Arnold Physical Therapy & Sports Medicine LLC | Clinic/Center | 11725 Manchester Rd, Des Peres, MO 63131-4616 | 2019-09-30 |
| 1477101376 | Ssm Select Rehab St. Louis, LLC | Clinic/Center | 33 Winfield Plz, Winfield, MO 63389-3451 | 2019-09-04 |
| 1104474006 | Ssm Select Rehab St. Louis, LLC | Clinic/Center | 508 W Veterans Memorial Pkwy, Warrenton, MO 63383-1046 | 2019-09-04 |
| 1497310932 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 201 Highway 34 West, Marble Hill, MO 63764 | 2019-05-09 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1548715402 | Specialty Rehab & Wellness | Clinic/Center | 3309 Crystal Lake Dr, Festus, Festus, MO 63028-4274 | 2016-08-22 |
| 1922414028 | Prorehab, PC | Clinic/Center | 8023 W Florissant Ave Ste A, Jennings, MO 63136-1448 | 2014-07-09 |
| 1831442540 | Invigorate Rehab Inc | Clinic/Center | 1722 Olive St Ste 201, Saint Louis, MO 63103-1700 | 2012-10-18 |
| 1144598574 | Health Facilities Rehab Services Inc | Clinic/Center | 323 Business Route 63, Thayer, MO 65791 | 2011-12-13 |
| Find all providers with the same taxonomy | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on SPORTS MEDICINE & TRAINING CENTER, LLC.
| 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.