Active NPI
Adam Manahan
- Occupational Therapist
- Saint Louis, MO
National Provider Identifier
1093351439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2019038231
- Practice address
- 1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181 - Phone
- (314) 652-4100
- NPI assigned
- Nov 20, 2019
- 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 | 2019038231 | MO | Primary |
Addresses
Primary practice location
1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Mailing address
9968 Adventure Pass
Noblesville, IN 46060-2224
Phone (636) 544-7085
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 |
|---|---|---|---|
| 2019038231 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1093351439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9968 ADVENTURE PASS",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460602224",
"telephone_number": "636-544-7085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JEFFERSON BARRACKS DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631254181",
"telephone_number": "314-652-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANAHAN",
"first_name": "ADAM",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-20",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2019038231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.