NPIMap

Organization Active NPI

Mitzi M. Cleary, Otd, Otr/L, Inc.

  • Occupational Therapist
  • Country Club, MO
National Provider Identifier
1144409624
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2003000911 Issued in MO
Legal business name
MITZI M. CLEARY, OTD, OTR/L, INC.
Practice address
18939 Evergreen Dr
Country Club, MO 64505-4058
Phone
(816) 383-0924
Fax
(816) 279-3094
NPI assigned
Oct 31, 2007
Last updated
Dec 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Authorized official

Name
Dr. Mitzi M. Cleary, OTD, OTR/LNPI 1407951791
Title
President
Phone
(816) 383-0924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1702329 KS
Occupational Therapist 225X00000X 2003000911 MO Primary

Addresses

Primary practice location

18939 Evergreen Dr
Country Club, MO 64505-4058

Mailing address

18939 Evergreen Dr
Country Club, MO 64505-4058
Phone (816) 383-0924

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1144409624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18939 EVERGREEN DR",
            "city": "COUNTRY CLUB",
            "state": "MO",
            "postal_code": "645054058",
            "telephone_number": "816-383-0924",
            "fax_number": "816-279-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18939 EVERGREEN DR",
            "city": "COUNTRY CLUB",
            "state": "MO",
            "postal_code": "645054058",
            "telephone_number": "816-383-0924",
            "fax_number": "816-279-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITZI M. CLEARY, OTD, OTR/L, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "CLEARY",
        "authorized_official_first_name": "MITZI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-383-0924",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "1702329",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2003000911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Country Club, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; 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.