Active NPI
Beth Ann Nichols, OTR
- Occupational Therapist
- Saint Peters, MO
National Provider Identifier
1104004373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 000926
- Practice address
- 324 Jungermann Rd
Saint Peters, MO 63376-5350 - Phone
- (636) 928-5327
- NPI assigned
- Feb 9, 2008
- 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 | 000926 | MO | Primary |
Addresses
Primary practice location
324 Jungermann Rd
Saint Peters, MO 63376-5350
Mailing address
6926 Fieldstone Farms Dr
O Fallon, MO 63368-8094
Phone (636) 300-9411
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 |
|---|---|---|---|
| 000926 | MO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leaps and Bounds, Inc. | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Occupational Therapist
- Saint Peters, MO
- NPI 1205017498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202515200000",
"number": "1104004373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6926 FIELDSTONE FARMS DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633688094",
"telephone_number": "636-300-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 JUNGERMANN RD",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633765350",
"telephone_number": "636-928-5327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "BETH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-09",
"last_updated": "2008-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "000926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.