NP HEALTH OF MO LLC – Physical Medicine & Rehabilitation Physician, NPI 1477170959
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NP HEALTH OF MO LLC
10 LAKE DR
BONNE TERRE, MO 636281820
Phone: (573) 358-2800
Fax: (573) 358-1090
Type: Location
415 W GOLF RD STE 26
ARLINGTON HEIGHTS, IL 600053923
Phone: (855) 700-8184
Fax: (224) 236-4700
Type: Mailing
4401 PARKER RD
FLORISSANT, MO 63033
Phone: (573) 358-2800
Fax: (573) 358-1090
Type: Location
9400 MARION AVE
MORTON GROVE, IL 600531255
Phone: (855) 611-8783
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-08-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (255 days ago).
Enrollment records
2
Earliest due date
2025-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200710000779 | O | Clinic/Group Practice | MO | 2025-09-30 |
| O20210831001081 | O | Clinic/Group Practice | KS | 2026-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63628)
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