MEDICARE: SUSTAINABLE PELVIC HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1073402442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSTAINABLE PELVIC HEALTH LLC

Provider Business Mailing Address
First Line	:	4050 PENNSYLVANIA AVE
Second Line	:	STE 115 #210
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3041
Country	:	US
Telephone Number	:	913-214-9956
Fax Number	:

Provider Business Practice Location Address
First Line	:	5661 TELEGRAPH RD STE 4B
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-4275
Country	:	US
Telephone Number	:	913-214-9956
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	AMBER SCHMITT
Credential	:	OTR/L
Telephone Number	:	913-214-9956

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/23/2025

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