BACK & SPINE MEDICAL INSTITUTE (NPI# 1871690081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871690081 |
| Entity Type | Organization |
| Organization Name | BACK & SPINE MEDICAL INSTITUTE |
| Practice Address |
5300 N Illinois St Fairview Heights IL 62208-3500 |
| Mailing Address |
1836 Lackland Hill Pkwy Saint Louis MO 63146-3572 |
| Practice Telephone | 6182222222 |
| Mailing Telephone | 3149890300 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-11-16 |
| Authorized Official Name | DR. RANDY JOHNSON (MD/OWNER) |
| Authorized Official Telephone | 3147818082 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE GROUP# | DE2495 | 01 |
| Street Address |
5300 N ILLINOIS ST |
| City | FAIRVIEW HEIGHTS |
| State | IL |
| Zip Code | 62208-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740236512 | Prorehab, PC | Clinic/Center | 5300 N Illinois St, Suite 101, Fairview Heights, IL 62208-3500 | 2006-05-25 |
| 1649517186 | Stacey Collins | Physical Therapist | 5300 N Illinois St, Ste. 101, Fairview Heights, IL 62208-3500 | 2013-01-03 |
| 1699024463 | Shawn T Wilcox | Hearing Instrument Specialist | 5300 N Illinois St, Fairview Heights, IL 62208-3500 | 2012-09-07 |
| 1447509328 | Les P Ham | Hearing Instrument Specialist | 5300 N Illinois St, Ste 105, Fairview Heights, IL 62208-3500 | 2012-09-06 |
| 1619241759 | Matthew W Weirich | Occupational Therapist | 5300 N Illinois St, Ste 101, Fairview Heights, IL 62208-3500 | 2012-03-07 |
| 1881982957 | Jessica A Durr | Physical Therapist | 5300 N Illinois St, Fairview Heights, Fairview Heights, IL 62208-3500 | 2011-07-11 |
| 1609171354 | Nicola J Poole-jones | Physical Therapist | 5300 N Illinois St, Suite 101, Fairview Heights, IL 62208-3500 | 2011-01-11 |
| 1740200690 | Dana Lynn Norris | Physical Therapist | 5300 N Illinois St, Fairview Heights, IL 62208-3500 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740829647 | Stephanie Lynn Arzavala-reed | Counselor | 8.5 Canty Lane, Fairview Heights, IL 62208 | 2019-12-26 |
| 1649822156 | Preferred Behavioral Health | Community/Behavioral Health | 141 Market Place Drive, Suite 100, Fairview Heights, IL 62208 | 2019-07-15 |
| 1164929055 | Itic Support Services Inc | Psychiatry & Neurology | 141 Market Pl Ste 100, Fairview Heights, IL 62208 | 2018-04-09 |
| 1023525102 | Karen E. Reinacher | Speech-Language Pathologist | 21 Circle Dr., Fairview Heights, IL 62208 | 2018-01-10 |
| 1316465297 | Rachel Moser | Behavioral Analyst | 9510 St. Clair Ave, Fairview Heights, IL 62208 | 2017-08-31 |
| 1952826471 | Tomika Eiland | Social Worker | 413 David Dr, Fairview Heights, IL 62208 | 2017-08-05 |
| 1194113852 | Rachel Logan | Social Worker | 10850 Lincoln Trail, Suite 16 #3, Fairview Heights, IL 62208 | 2015-01-05 |
| 1255746715 | Center for Advanced Medicine LLC | Internal Medicine | 5036 N Illinois St, Suite 1, Fairview Heights, IL 62208 | 2014-06-24 |
| 1033463393 | Katherine Johnson I | Physical Therapy Assistant | 320 N Ruby Ln, Fairview Heights, IL 62208 | 2012-11-07 |
| 1508118779 | Nicole Kovacic | Physical Therapy Assistant | 5501 Perrin Drive, Fairview Heights, IL 62208 | 2012-10-11 |
| Find all providers in zip 62208 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437283520 | Jessica L Muehl | Physical Therapist | 5300 N Illinois, Suite 101, Fairview Heights, IL 32208-2700 | 2007-03-14 |
| 1982738050 | Sara J Hilgedieck | Physical Therapist | 13 Executive Drive, Ste. 18, Fairview Heights, IL 62208 | 2007-03-14 |
| 1659460558 | Adam Muehl | Physical Therapist | 5900 N Illinois St, Ste 9, Fairview Heights, IL 62208-2700 | 2006-10-11 |
| 1962416917 | Jennifer Thompson | Physical Therapist | 18 Plaza Dr, Fairview Heights, IL 62208-2025 | 2006-07-27 |
| 1063452308 | Kristen R Thompson | Physical Therapist | 10607 Lincoln Trl, Fairview Heights, IL 62208-1913 | 2006-06-07 |
| 1134610298 | Vernon C Modglin | Physical Therapist | 5300 N Illinois St Ste 101, Fairview Heights, IL 62208-3500 | 2018-05-24 |
| 1619305141 | Allison Schaal | Physical Therapist | 141 Market Pl, Fairview Heights, IL 62208-2034 | 2013-10-18 |
| 1649517186 | Stacey Collins | Physical Therapist | 5300 N Illinois St, Ste. 101, Fairview Heights, IL 62208-3500 | 2013-01-03 |
| 1881982957 | Jessica A Durr | Physical Therapist | 5300 N Illinois St, Fairview Heights, Fairview Heights, IL 62208-3500 | 2011-07-11 |
| 1609171354 | Nicola J Poole-jones | Physical Therapist | 5300 N Illinois St, Suite 101, Fairview Heights, IL 62208-3500 | 2011-01-11 |
| Find all providers in FAIRVIEW HEIGHTS | ||||
| City | FAIRVIEW HEIGHTS |
| Zip Code | 62208 |
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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.