Active NPI
Megan Lee Wallis, OTD, OTR/L
- Occupational Therapist
- Saint Louis, MO
National Provider Identifier
1124849799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2024039348
- Practice address
- 1000 Executive Parkway Dr Ste 120
Saint Louis, MO 63141-6369 - Phone
- (314) 828-1443
- NPI assigned
- Oct 17, 2024
- 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 | 2024039348 | MO | Primary |
Addresses
Primary practice location
1000 Executive Parkway Dr Ste 120
Saint Louis, MO 63141-6369
Mailing address
7901 Cornell Ave
University City, MO 63130-3704
Phone (636) 368-5972
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 |
|---|---|---|---|
| 2024039348 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729123200000",
"number": "1124849799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7901 CORNELL AVE",
"city": "UNIVERSITY CITY",
"state": "MO",
"postal_code": "631303704",
"telephone_number": "636-368-5972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 EXECUTIVE PARKWAY DR STE 120",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416369",
"telephone_number": "314-828-1443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLIS",
"first_name": "MEGAN",
"middle_name": "LEE",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-17",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2024039348",
"primary": true
}
],
"identifiers": [],
"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 Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.