Lifetime Redesign OT, PLLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

LIFETIME REDESIGN OT, PLLC

Practice address

12395 Olive Blvd Ste 200
Saint Louis, MO 63141-5465

Phone

(646) 319-9017

NPI assigned

Mar 22, 2022

Last updated

May 29, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph MitchellNPI 1952669152

Title

Authorized Official

Phone

(270) 993-4789

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MO, NC3 enrollments

Enrollment records 3

Locations

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Lee Mitchell, M.D.

  • Family Medicine Physician
  • Goshen, KY
  • NPI 1952669152

  Geriatric Medicine, MO, NC

  Medicare reassignment Care Compare group NPD Authorized official
• Leah Teichmiller, PA

  • Physician Assistant
  • Mattoon, IL
  • NPI 1710433529

  MO

  Medicare reassignment Care Compare group
• Taylor Olivia Alvarez, OTR

  • Occupational Therapist
  • New York, NY
  • NPI 1043062805

  Environmental Modification

  Medicare reassignment NPD
• Walter A Bryant Jr., OTR/L

  • Occupational Therapist
  • Queens Village, NY
  • NPI 1730794942
  Medicare reassignment NPD
• Justin M Chacko

  • Occupational Therapist
  • Brooklyn, NY
  • NPI 1922430743
  Medicare reassignment NPD
• Daniel Elliot, OTR/L

  • Occupational Therapist
  • Plainview, NY
  • NPI 1891209201
  Medicare reassignment NPD
• Rachel Harrington

  • Occupational Therapist
  • Franklin Square, NY
  • NPI 1669291423
  Medicare reassignment NPD
• Brendan Kiernan

  • Occupational Therapist
  • Philadelphia, PA
  • NPI 1689020638

  NY

  Medicare reassignment NPD
• Mary Patricia Prostick, OTRL

  • Occupational Therapist
  • Albany, NY
  • NPI 1477611754
  Medicare reassignment NPD
• Heidi Richter, OTR/L

  • Occupational Therapist
  • New York, NY
  • NPI 1265071625
  Medicare reassignment NPD
• Alana Natasia Zimmer

  • Occupational Therapist
  • New York, NY
  • NPI 1104521251
  Medicare reassignment NPD
• Paola G Chang, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
  • NPI 1184443152
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1013666403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 S MICHIGAN AVE STE 13138",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052810",
            "telephone_number": "646-319-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 OLIVE BLVD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415465",
            "telephone_number": "646-319-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME REDESIGN OT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "270-993-4789"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C. (Premier Dental Partners Oral Surgery and Dental Implant Center)
• Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C. (Premier Dental Partners Downtown)
• Lifetime Support Services, LLC
• Lifevision, Inc. (Physical Therapy Innovations)
• Lifewave Technology Group LLC
• Lifework Transitions, LLC
• Lifework, LLC

• Geriatric Medicine (Family Medicine) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Geriatric Medicine (Family Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.