BESPOKE PHYSICAL THERAPY, WELLNESS AND PERFORMANCE
NPI 1508715756
Physical Therapist in Wildwood, MO

Active since January 22, 2026
17014 NEW COLLEGE AVE STE D, WILDWOOD, MO 63040(636) 500-7772 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 26, 2026, Jan 22, 2026 (2 updates tracked since 2026).

About Bespoke Physical Therapy, Wellness And Performance NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BESPOKE PHYSICAL THERAPY, WELLNESS AND PERFORMANCE (NPI 1508715756) is a healthcare organization registered as a physical therapist in Wildwood, Missouri and active in the NPI registry since January 2026. The organization lists Taylor Bushnell, Owner/physical Therapist, as its authorized official.

NPPES Registry Identity

NPI1508715756
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameBESPOKE PHYSICAL THERAPY, WELLNESS AND PERFORMANCE
Location Address17014 NEW COLLEGE AVE STE DWildwood, MO 63040-1177
Mailing Address17014 New College Ave Ste DWildwood, MO 63040-1177 · (636) 500-7772
Organization SubpartNo
Authorized OfficialTaylor BushnellOwner/physical Therapist · (636) 500-7772
Enumeration DateJanuary 22, 2026
Last NPPES UpdateJanuary 26, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2026
✔ NPI 1508715756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
17014 NEW COLLEGE AVE STE D, Wildwood, MO 63040

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bespoke Physical Therapy, Wellness And Performance is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Bespoke Physical Therapy, Wellness And Performance, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Physical Therapist in Private Practice
NPI 1558692566
17014 NEW COLLEGE AVE
Wildwood, MO 63040
(636) 500-7772
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1710426432
15425 MANCHESTER RD SUITE 28
Ballwin, MO 63011
(636) 220-6969
✔ Accepts Medicare4.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Roberta February 27, 2026

5/5
I cannot recommend Taylor enough, he is simply terrific! He really listens, understands your goals (including wanting to keep training even when you’re dealing with pain), and works with you to strengthen your weaknesses while helping you recover.
Office Staff 5/5
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bespoke Physical Therapy, Wellness And Performance's NPI number?

The NPI number for Bespoke Physical Therapy, Wellness And Performance is 1508715756. It was assigned to this organization in the NPPES registry on January 22, 2026.

Where is Bespoke Physical Therapy, Wellness And Performance located?

Bespoke Physical Therapy, Wellness And Performance is located at 17014 New College Ave Ste D, Wildwood, MO 63040. The listed phone number is (636) 500-7772.

What is Bespoke Physical Therapy, Wellness And Performance's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Bespoke Physical Therapy, Wellness And Performance enrolled in Medicare?

Yes. Bespoke Physical Therapy, Wellness And Performance is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bespoke Physical Therapy, Wellness And Performance?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Bespoke Physical Therapy, Wellness And Performance. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bespoke Physical Therapy, Wellness And Performance was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.