ST. CHARLES SPORTS&PHYSICAL THERAPY, INC. (NPI# 1467655118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467655118 |
| Entity Type | Organization |
| Organization Name | ST. CHARLES SPORTS&PHYSICAL THERAPY, INC. |
| Practice Address |
1155 Wentzville Pkwy Ste 123 Wentzville MO 63385-3476 |
| Mailing Address |
939 Highway K O Fallon MO 63366-2910 |
| Practice Telephone | 6363321313 |
| Practice Fax Number | 6363322929 |
| Mailing Telephone | 6362407000 |
| Mailing Fax Number | 6362407513 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MONIKA WILSON (BUSINESS DIRECTOR) |
| Authorized Official Telephone | 6362407000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | MO | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164535217 | St. Charles Sports&physical Therapy, Inc. | Physical Therapist | 1840 Zumbehl Rd, Saint Charles, MO 63303-2761 | 2006-08-15 |
| 1356545750 | St. Charles Sports&physical Therapy, Inc. | Prosthetic/Orthotic Supplier | 1840 Zumbehl Rd, Saint Charles, MO 63303-2761 | 2007-06-12 |
| 1841494317 | St. Charles Sports&physical Therapy, Inc. | Prosthetic/Orthotic Supplier | 263 Centre Pointe Drive, St. Peters, MO 63376-7300 | 2007-06-11 |
| 1932302676 | St. Charles Sports&physical Therapy, Inc. | Prosthetic/Orthotic Supplier | 939 Highway K, O Fallon, MO 63366-2910 | 2007-06-08 |
| Street Address |
1155 WENTZVILLE PKWY STE 123 |
| City | WENTZVILLE |
| State | MO |
| Zip Code | 63385-3476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811948813 | Diane Lynn Palombi | Optometrist | 1155 Wentzville Pkwy, Suite 119, Wentzville, MO 63385-3476 | 2006-05-14 |
| 1205269768 | Eric Henson | Physical Therapist | 1155 Wentzville Pkwy, Suite 123, Wentzville, MO 63385-3476 | 2013-08-19 |
| 1528378437 | Palombi Vision Center PC | Clinic/Center | 1155 Wentzville Pkwy, Suite 119, Wentzville, MO 63385-3476 | 2010-10-13 |
| 1164535662 | Christine M Cicotte | Physical Therapist | 1155 Wentzville Pkwy, Suite 123, Wentzville, MO 63385-3476 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730243 | Jeffery William Ellis | Pharmacist | 1571 Wentzville Parkway, Wentzville, MO 63385 | 2020-11-05 |
| 1487266011 | Jason Wade Moore | Peer Specialist | 5 West Pearce Boulevard, Wentzville, MO 63385 | 2020-08-17 |
| 1265906176 | Montrice M Haynes | Counselor | 500 Medical Dr., Central Intake, Wentzville, MO 63385 | 2019-01-14 |
| 1841718459 | Linda Duree | Counselor | 7105 Whisper Creek Dr, Wentzville, MO 63385 | 2017-09-03 |
| 1811349368 | Sara Kleinlein | Social Worker | 500 Medical Drive, Wentzville, MO 63385 | 2016-07-08 |
| 1275980757 | Teona Moeller | Nurse Practitioner | 1598 West Meyer Dr., Wentzville, MO 63385 | 2016-05-16 |
| 1831561273 | Jay F. Hauser, Dds, PC | Dentist | 11 Wentzville Bluffs Drive, Wentzville, MO 63385 | 2015-10-26 |
| 1720402035 | Shara Kuehl | Speech-Language Pathologist | One Campus Drive, Wentzville, MO 63385 | 2014-02-06 |
| 1336480474 | Simply Loyal In Home and Transport Services LLC | Home Health | 152 Enterprise Dr, Wentzille, MO 63385 | 2013-03-14 |
| 1750641338 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1849 Wentzville Parkway, Wentzville, MO 63385 | 2012-05-17 |
| Find all providers in zip 63385 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720540313 | Axes Physical Therapy, LLC | Prosthetic/Orthotic Supplier | 754 Luetkenhaus Blvd, Wentzville, MO 63385-3515 | 2019-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355689 | Hair On The Edge | Prosthetic/Orthotic Supplier | 9708 Lackland Rd, Overland, MO 63114-3414 | 2020-10-28 |
| 1427656727 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 755 S New Ballas Rd Ste 140, Saint Louis, MO 63141-8713 | 2020-10-09 |
| 1437783776 | Mager & Gougelman of St. Louis, LLC | Prosthetic/Orthotic Supplier | 1034 S Brentwood Blvd Ste 1880, Richmond Heights, MO 63117-1218 | 2020-02-25 |
| 1962042440 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 9665 Page Avenue, Overland, MO 63132 | 2020-01-13 |
| 1407496201 | Ortheco LLC | Prosthetic/Orthotic Supplier | 2907 Independence St Ste D, Cape Girardeau, MO 63703-5027 | 2020-01-09 |
| 1477100717 | Desirae Clark | Prosthetic/Orthotic Supplier | 5100 Lydia Ave, Kansas City, MO 64110-2608 | 2019-08-21 |
| 1093272460 | Axes Physical Therapy I, LLC | Prosthetic/Orthotic Supplier | 2018 Phoenix Center Dr, Washington, MO 63090-5544 | 2019-02-21 |
| 1215400312 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 4801 Main St Ste 220, Kansas City, MO 64112-2929 | 2019-01-10 |
| 1649778382 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 50 Crestwood Executive Ctr Ste 315, Saint Louis, MO 63126-1900 | 2018-01-29 |
| 1356858971 | Monique Renee Wigs and Etc | Prosthetic/Orthotic Supplier | 12123 Blue Ridge Ext Ste C, Grandview, MO 64030-1194 | 2018-01-04 |
| Find all providers with the same taxonomy | ||||
| City | WENTZVILLE |
| Zip Code | 63385 |
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| 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.