Active NPI
Amanda Shulman, MS, OTR/L
- Occupational Therapist
- Bridgeton, MO
National Provider Identifier
1083019459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2012002303
- Practice address
- 12380 Depaul Drive
Bridgeton, MO 63044 - Phone
- (314) 447-9710
- Fax
- (314) 447-9711
- NPI assigned
- Oct 28, 2014
- 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 Therapist | 225X00000X | 2012002303 | MO | Primary |
Addresses
Primary practice location
12380 Depaul Drive
Bridgeton, MO 63044
Mailing address
12380 Depaul Drive
Bridgeton, MO 63044
Phone (314) 447-9710
Other practice location 1
4 Arnold Park Mall
Arnold, MO 63010
Phone (636) 282-0056
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)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Clinical Care | Occupational Therapist | Past | Accepting new patients |
| SSM Select Rehab St Louis LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Medicine & Rehabilitation Physician
- Richmond Heights, MO
- NPI 1558403261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568764800000",
"number": "1083019459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12380 DEPAUL DRIVE",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "63044",
"telephone_number": "314-447-9710",
"fax_number": "314-447-9711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12380 DEPAUL DRIVE",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "63044",
"telephone_number": "314-447-9710",
"fax_number": "314-447-9711"
}
],
"practiceLocations": [
{
"address_1": "4 Arnold Park Mall",
"address_purpose": "LOCATION",
"city": "Arnold",
"state": "MO",
"postal_code": "63010",
"country_code": "US",
"telephone_number": "636-282-0056",
"fax_number": "636-282-0057",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHULMAN",
"first_name": "AMANDA",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-28",
"last_updated": "2019-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2012002303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.