Active NPI
Sierra Keller, COTA/L
- Occupational Therapy Assistant
- Houston, MO
National Provider Identifier
1033973193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2020036317
- Practice address
- 206 W Spruce St
Houston, MO 65483-1126 - Phone
- (417) 967-3024
- NPI assigned
- Feb 9, 2024
- Last updated
- Feb 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2020036317 | MO | Primary |
Addresses
Primary practice location
206 W Spruce St
Houston, MO 65483-1126
Mailing address
905 Hill Street
Houston, MO 65483
Phone (417) 967-3196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020036317 | MO | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1033973193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 HILL STREET",
"city": "HOUSTON",
"state": "MO",
"postal_code": "65483",
"telephone_number": "417-967-3196",
"fax_number": "417-967-2923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 W SPRUCE ST",
"city": "HOUSTON",
"state": "MO",
"postal_code": "654831126",
"telephone_number": "417-967-3024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "SIERRA",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-09",
"last_updated": "2024-02-09",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MO",
"license": "2020036317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.