Individual provider Active NPI

Lyndsey Patterson, OTR/L

  • Occupational Therapist
  • Jefferson City, MO
National Provider Identifier
1063991305
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
402519 Issued in MO
Practice address
205 Jefferson St
Jefferson City, MO 65101-2901
Phone
(573) 751-4427
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 402519 MO Primary

Addresses

Primary practice location

205 Jefferson St
Jefferson City, MO 65101-2901

Mailing address

13325 Kenroyal Dr
Des Peres, MO 63131-1927
Phone (314) 322-3495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515002523 MO Practitioner - Occupational Therapist in Private Practice 1658840970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smart Rehab, LLCGroup PAC ID 1759668643, 23 clinicians

Practice addresses (Care Compare)

524 S Crescent Dr
Kirkwood, MO 63122-4629
Phone (314) 686-1309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
402519MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Therapy Inc Current Accepting new patients
Missouri Schools for the Severely Disabled Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1063991305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13325 KENROYAL DR",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311927",
            "telephone_number": "314-322-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 JEFFERSON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651012901",
            "telephone_number": "573-751-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "LYNDSEY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "402519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.