Active NPI
Sean Evans, OTR/L
- Occupational Therapist
- Osage Beach, MO
National Provider Identifier
1053980391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 872 College Blvd
Osage Beach, MO 65065-8408 - Phone
- (573) 302-0900
- NPI assigned
- Jun 22, 2021
- Sex
- Male
- 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 Therapist | 225X00000X | Primary |
Addresses
Primary practice location
872 College Blvd
Osage Beach, MO 65065-8408
Mailing address
55 Lee Dr
Holts Summit, MO 65043-1121
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1053980391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 LEE DR",
"city": "HOLTS SUMMIT",
"state": "MO",
"postal_code": "650431121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 COLLEGE BLVD",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650658408",
"telephone_number": "573-302-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SEAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Osage Beach, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.