SPORTS MEDICINE AND TRAINING CENTER, LLC (NPI# 1013264837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013264837 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE AND TRAINING CENTER, LLC |
| Practice Address |
8235 Clayton Rd Saint Louis MO 63117-1107 |
| Mailing Address |
119 Watson Plz Saint Louis MO 63126-1962 |
| Practice Telephone | 3149613787 |
| Practice Fax Number | 3143387754 |
| Mailing Telephone | 3149613787 |
| Mailing Fax Number | 3149610974 |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2012-08-10 |
| Authorized Official Name | MRS. ROBERTA H VANNEST (OWNER) |
| Authorized Official Telephone | 3149613787 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
8235 CLAYTON RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942445226 | Timothy Patrick Trupiano | Specialist/Technologist | 8235 Clayton Rd, Saint Louis, MO 63117-1107 | 2008-12-15 |
| 1801142856 | Patrick James Mitchell | Physical Therapist | 8235 Clayton Rd, Saint Louis, MO 63117-1107 | 2012-07-27 |
| 1356608897 | John Patrick Young | Specialist/Technologist | 8235 Clayton Rd, Saint Louis, MO 63117-1107 | 2012-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053820175 | Prorehab PC | Clinic/Center | 11525 Olde Cabin Rd Ste 1, Saint Louis, MO 63141-7146 | 2017-09-20 |
| 1811447840 | Crystal Cunetto | Clinic/Center | 1114 Ridgelynn Dr, Saint Louis, MO 63124-1220 | 2016-10-13 |
| 1720429558 | Missouri Physical Therapy LLC | Clinic/Center | 9751 Clayton Rd, Saint Louis, MO 63124-1503 | 2013-07-09 |
| 1205067857 | Therapeutic Innovations Lc | Clinic/Center | 563 Cliff Cave Rd, Saint Louis, MO 63129-4415 | 2009-07-30 |
| 1639200074 | Occupational Health Centers of Kansas Pa | Clinic/Center | 1617 S 3rd St, Saint Louis, MO 63104-3839 | 2007-03-08 |
| 1629109087 | Occupational Health Centers of Kansas Pa | Clinic/Center | 8340 N Broadway, Saint Louis, MO 63147-2333 | 2007-03-08 |
| 1194778183 | Prorehab, PC | Clinic/Center | 3726 S Kingshighway Blvd, Saint Louis, MO 63109-1800 | 2006-05-18 |
| 1124071238 | Prorehab, PC | Clinic/Center | 107 Concord Plaza Shopping Ctr, Saint Louis, MO 63128-1307 | 2006-05-18 |
| 1336122266 | Brentwood Physical Therapy Limited | Clinic/Center | 2558 S Brentwood Blvd, Saint Louis, MO 63144-2309 | 2005-11-23 |
| 1699269928 | Physical Therapy Collective, LLC | Clinic/Center | 4642 Shenandoah Ave, Saint Louis, MO 63110-3424 | 2018-06-20 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
Please comment or provide details below to improve the information on SPORTS MEDICINE AND 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.