Individual provider Active NPI

Miriam Aline Brinley, OTR/L

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1104266790
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2013015661 Issued in MO
Practice address
11960 Westline Industrial Dr
Ste 201
Saint Louis, MO 63146-3209
Phone
(866) 433-9555
NPI assigned
Jun 27, 2013
Last updated
Jun 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2013015661 MO Primary

Addresses

Primary practice location

11960 Westline Industrial Dr
Ste 201
Saint Louis, MO 63146-3209

Mailing address

4557B Chouteau Ave
Saint Louis, MO 63110-1517
Phone (202) 329-8792

Other identifiers 1

IdentifierTypeStateIssuer
2013015661OtherMOMISSOURI DIVISION OF PROFESSIONAL REGISTRATION, OCCUPATIONAL THERAPY BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260126001235 DC Practitioner - Occupational Therapist in Private Practice 7719464387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10133 Sherrill Blvd
Suite 200
Knoxville, TN 37932-3347

500 W Jefferson St
Louisville, KY 40202-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013015661MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Occupational Therapist CurrentSince Dec 14, 2025 Accepting new patients
Supplemental Health Care Past Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1104266790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4557B CHOUTEAU AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101517",
            "telephone_number": "202-329-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR",
            "address_2": "STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209",
            "telephone_number": "866-433-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINLEY",
        "first_name": "MIRIAM",
        "middle_name": "ALINE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2013015661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI DIVISION OF PROFESSIONAL REGISTRATION, OCCUPATIONAL THERAPY BOARD",
            "identifier": "2013015661",
            "state": "MO"
        }
    ],
    "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 Jun 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.