Healthcare Provider Details

I. General information

NPI: 1043753551
Provider Name (Legal Business Name): SHELBY SCHAEFER PT, DPT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14775 SILVER SNIPE ST STE F
ASHLAND MO
65010-4204
US

IV. Provider business mailing address

647 SPIRIT AIRPARK WEST DR STE 101
CHESTERFIELD MO
63005-1032
US

V. Phone/Fax

Practice location:
  • Phone: 573-554-3752
  • Fax:
Mailing address:
  • Phone: 636-223-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number28525
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2026014901
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: