Individual provider Active NPI

Brittan Rachel Bossert

  • Occupational Therapist
  • Sikeston, MO
National Provider Identifier
1114576014
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2019031661 Issued in MO
Practice address
300 Floyd Dr
Sikeston, MO 63801-3960
Phone
(573) 472-0397
Fax
(573) 472-0409
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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 2019031661 MO Primary

Addresses

Primary practice location

300 Floyd Dr
Sikeston, MO 63801-3960

Mailing address

PO Box 608
Sikeston, MO 63801-0608
Phone (573) 472-0397

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
2019031661MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenny Rogers Children'S Center Occupational Therapist PastSince Sep 8, 2019 Accepting new patients
Mercy Clinic Children'S Surgery, LLC PastSince Sep 8, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1114576014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638010608",
            "telephone_number": "573-472-0397",
            "fax_number": "573-472-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FLOYD DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638013960",
            "telephone_number": "573-472-0397",
            "fax_number": "573-472-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSERT",
        "first_name": "BRITTAN",
        "middle_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2019031661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.