Active NPI
Nicole R Boydston, MOT, OTR/L
- Occupational Therapist
- Kansas City, MO
National Provider Identifier
1093066300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 113854
- Practice address
- 11601 N Harrison St
Kansas City, MO 64155-1581 - Phone
- (816) 589-5695
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 113854 | MO | Primary |
Addresses
Primary practice location
11601 N Harrison St
Kansas City, MO 64155-1581
Mailing address
11601 N Harrison St
Kansas City, MO 64155-1581
Phone (816) 589-5695
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113854 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1093066300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11601 N HARRISON ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641551581",
"telephone_number": "816-589-5695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11601 N HARRISON ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641551581",
"telephone_number": "816-589-5695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYDSTON",
"first_name": "NICOLE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "MOT, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-26",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "113854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.