STARZ PEDIATRIC THERAPY NETWORK (NPI# 1518261320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518261320 |
| Entity Type | Organization |
| Organization Name | STARZ PEDIATRIC THERAPY NETWORK |
| Practice Address |
640 Nw Jefferson St Grain Valley MO 64029-8278 |
| Mailing Address |
1302 Nw Persimmon Dr Grain Valley MO 64029-8628 |
| Practice Telephone | 8167267337 |
| Practice Fax Number | 8168470218 |
| Mailing Telephone | 8167267337 |
| Mailing Fax Number | 8168470218 |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2012-08-28 |
| Authorized Official Name | STACEE NEWSOM (PHYSICAL THERAPIST, OWNER) |
| Authorized Official Telephone | 8167267337 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities | ||
| N | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities | ||
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1518261320 | 05 |
| Street Address |
640 NW JEFFERSON ST |
| City | GRAIN VALLEY |
| State | MO |
| Zip Code | 64029-8278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023205671 | Stacee Newsom | Physical Therapist | 640 Nw Jefferson St, Grain Valley, MO 64029-8278 | 2007-09-27 |
| 1437501251 | Caitlin Robinson | Physical Therapist | 640 Nw Jefferson St, Grain Valley, MO 64029-8278 | 2016-07-05 |
| 1275935124 | Michelle Grace Clark | Speech-Language Pathologist | 640 Nw Jefferson St, Grain Valley, MO 64029-8278 | 2014-09-23 |
| 1366863995 | Nicole Carrillo | Speech-Language Pathologist | 640 Nw Jefferson St, Grain Valley, MO 64029-8278 | 2013-12-28 |
| 1124453014 | Monica R Carrier | Occupational Therapist | 640 Nw Jefferson St, Grain Valley, MO 64029-8278 | 2013-09-10 |
| 1841554532 | Vanessa Sue Coonce | Speech-Language Pathologist | 640 Nw Jefferson St, Grain Valley, MO 64029-8278 | 2012-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1336655299 | Cosentino Enterprises Inc | Pharmacy | 1191 Ne Mcquerry Road, Grain Valley, MO 64029 | 2017-12-14 |
| 1427238922 | Tracy Dee Dryer | Pharmacist | 301 Sw Eagle's Parkway, Grain Valley, MO 64029 | 2007-11-13 |
| 1184822736 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1800 Nw Duncan Rd, Grain Valley, MO 64029 | 2007-07-05 |
| 1740486711 | Re-new Life | Counselor | 33204 E. R.d. Mize Road, Grain Valley, MO 64029 | 2007-06-26 |
| 1891822524 | Julia Rachele Loecker | Dentist | 1424 Sw Eagles Parkway, Grain Valley, MO 64029 | 2007-02-28 |
| 1578667192 | Bds Pharmaceutical Inc | Pharmacy | 1400 Sw Eagles Parkway, Grain Valley, MO 64029 | 2006-09-12 |
| 1376575480 | Kurt Frederick Hanneman | Dentist | 655 R.d. Mize Road, Grain Valley, MO 64029 | 2006-07-07 |
| 1144832569 | Crosetti Health and Wellness | Pharmacy | 510 N Main St, Grain Valley, MO 64029 | 2020-08-18 |
| 1528273471 | Katrina Marie Tarpenning | Pharmacist | 1400 Sw Eagles Pkwy, Grain Valley, MO 64029 | 2007-05-14 |
| Find all providers in zip 64029 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013311257 | Serc Rehabilitation Partners LLC | Clinic/Center | 103 Sw Eagles Pkwy, Grain Valley, MO 64029-8512 | 2014-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417563479 | Lydia Kay Blondin | Clinic/Center | 24158 Tanglewood Rd, Saint Robert, MO 65584-3815 | 2020-09-16 |
| 1275146474 | Beyond Recovery Physical Therapy, LLC | Clinic/Center | 2627 E Horning St, Springfield, MO 65802-2372 | 2020-08-26 |
| 1144839887 | Atr Justin LLC | Clinic/Center | 15882 Clayton Rd, Ellisville, MO 63011-2212 | 2020-07-29 |
| 1043836588 | Martin Ventures LLC | Clinic/Center | 3119 S Scenic Ave Ste B, Springfield, MO 65807-3965 | 2020-06-21 |
| 1659996585 | Suellen Caroline Cruz Johnson | Clinic/Center | 1120 E 77th Ter, Kansas City, MO 64131-1939 | 2020-06-16 |
| 1790252948 | Mercy Hospital Springfield | Clinic/Center | 448 Hwy 248 Ste 130, Branson, MO 65616-3725 | 2018-10-25 |
| 1477059517 | Occupational Health Centers of Kansas Pa | Clinic/Center | 19000 E Eastland Center Ct Ste 200, Independence, MO 64055-7023 | 2018-04-05 |
| 1326541475 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 1 Pratt Pl, Florissant, MO 63031-6557 | 2018-03-15 |
| 1053820175 | Prorehab PC | Clinic/Center | 11525 Olde Cabin Rd Ste 1, Saint Louis, MO 63141-7146 | 2017-09-20 |
| 1629590955 | Judice Consulting LLC | Clinic/Center | 700 Shallowcreek Vw, Ballwin, MO 63021-6618 | 2017-07-07 |
| Find all providers with the same taxonomy | ||||
| City | GRAIN VALLEY |
| Zip Code | 64029 |
Please comment or provide details below to improve the information on STARZ PEDIATRIC THERAPY NETWORK.
| 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.