Individual provider Active NPI

Justine Erin Troske, MSOT, OTR/L

  • Pediatric Occupational Therapist
  • Bolivar, MO
National Provider Identifier
1144629056
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
2014004167 Issued in MO
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 328-6515
Fax
(417) 328-6716
NPI assigned
Aug 15, 2014
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 2014004167 MO Primary

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3011

Mailing address

680 N Holt Ave
Bolivar, MO 65613-1492
Phone (636) 212-0764

Other names 1

  • Ms. Justine Erin Troske Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230320002258 MO Practitioner - Occupational Therapist in Private Practice 7618341397 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014004167MOMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services OT Mo LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

3330 Ehlmann Rd
Saint Charles, MO 63301
Phone (636) 205-1056

10199 Woodfield Ln
Saint Louis, MO 63132
Phone (314) 485-5845

1650 High St
Washington, MO 63090
Phone (636) 390-3290

7 Carnegie Plz
Cherry Hill, NJ 08003

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1144629056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N HOLT AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131492",
            "telephone_number": "636-212-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-328-6515",
            "fax_number": "417-328-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROSKE",
        "first_name": "JUSTINE",
        "middle_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MO",
            "license": "2014004167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "TROSKE",
            "middle_name": "ERIN",
            "prefix": "MS.",
            "credential": "MSOT, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolivar, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.