MGM Therapy Solutions LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

MGM THERAPY SOLUTIONS LLC

Practice address

10037 County Road 625
Dexter, MO 63841-8688

Phone

(870) 926-7481

NPI assigned

Jan 6, 2025

Organization subpart

No

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

Authorized official

Name

Mallory G McCallisterNPI 1093350712

Title

Owner/Ceo

Phone

(870) 926-7481

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mallory McCallister, OTD, OTR/L

  • Occupational Therapist
  • Blytheville, AR
  • NPI 1093350712
  NPD Authorized official

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1053120824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10037 COUNTY ROAD 625",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638418688",
            "telephone_number": "870-926-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10037 COUNTY ROAD 625",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638418688",
            "telephone_number": "870-926-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM THERAPY SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "MCCALLISTER",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "870-926-7481"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Lynn McGowan, LPC
• Amy Mekan, RN
• Memory Lane of Dexter, LLC
• Aaron Kate Menley
• Meramec Emergency Physicians, LLP
• Jessica L Miller, DNP, NP-C
• John Dale Minton, DMD
• Naveed Javaid Mirza, MD
• Rubina A Mirza, MD
• Missouri Delta Medical Center

• Early Intervention Provider Agency in Dexter, MO
• Providers in Dexter, MO by specialty
• Early Intervention Provider Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.