NPIMap

Individual provider Active NPI

Kimberly Obholz, OT

  • Occupational Therapist
  • Creve Coeur, MO
National Provider Identifier
1124299243
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2007023062 Issued in MO
Practice address
10560 Old Olive Street Rd
Suite 100
Creve Coeur, MO 63141-5916
Phone
(314) 567-4707
Fax
(314) 567-4505
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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 2007023062 MO Primary

Addresses

Primary practice location

10560 Old Olive Street Rd
Suite 100
Creve Coeur, MO 63141-5916

Mailing address

1209 Washington Ave.
Ste. 811
St. Louis, MO 63103
Phone (314) 606-3401

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
2007023062MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sensory Solutions, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1124299243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 WASHINGTON AVE.",
            "address_2": "STE. 811",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63103",
            "telephone_number": "314-606-3401",
            "fax_number": "314-567-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 OLD OLIVE STREET RD",
            "address_2": "SUITE 100",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415916",
            "telephone_number": "314-567-4707",
            "fax_number": "314-567-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBHOLZ",
        "first_name": "KIMBERLY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2007023062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.