Individual provider Active NPI

Kathleen E Pryor

  • Occupational Therapist
  • Wentzville, MO
National Provider Identifier
1104394311
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2013026524 Issued in MO
Practice address
280 Interstate Dr
Wentzville, MO 63385-4510
Phone
(636) 327-3800
Fax
(636) 327-3800
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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 2013026524 MO Primary

Addresses

Primary practice location

280 Interstate Dr
Wentzville, MO 63385-4510

Mailing address

280 Interstate Dr
Wentzville, MO 63385-4510
Phone (636) 327-3800

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

LicenseStateTypeSpecialty
2013026524MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wentzville School District PastSince Oct 21, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1104394311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 INTERSTATE DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854510",
            "telephone_number": "636-327-3800",
            "fax_number": "636-327-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 INTERSTATE DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854510",
            "telephone_number": "636-327-3800",
            "fax_number": "636-327-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "KATHLEEN",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2013026524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.