Active NPI
Derek Mehrl
- Occupational Therapist
- Clive, IA
National Provider Identifier
1083349575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 097034
- Practice address
- 1401 Campus Dr
Clive, IA 50325-6500 - Phone
- (515) 381-6519
- NPI assigned
- Jul 19, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 278766 | KY | |
| Occupational Therapist | 225X00000X | 097034 | IA | Primary |
Addresses
Primary practice location
1401 Campus Dr
Clive, IA 50325-6500
Mailing address
4850 Augusta LN
Pleasant Hill, IA 50327-7086
Phone (515) 210-8713
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 |
|---|---|---|---|
| 097034 | IA | MD | Occupational Therapist |
| 278766 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658188800000",
"number": "1083349575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4850 AUGUSTA LN",
"city": "PLEASANT HILL",
"state": "IA",
"postal_code": "503277086",
"telephone_number": "515-210-8713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 CAMPUS DR",
"city": "CLIVE",
"state": "IA",
"postal_code": "503256500",
"telephone_number": "515-381-6519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHRL",
"first_name": "DEREK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-19",
"last_updated": "2022-07-19",
"certification_date": "2022-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "278766",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "097034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.