Individual provider Active NPI

Kelly Fallert, OTR/L

  • Occupational Therapist
  • Sainte Genevieve, MO
National Provider Identifier
1144691288
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2000163364 Issued in MO
Practice address
1010 Ste Genevieve Dr
Sainte Genevieve, MO 63670-1447
Phone
(573) 883-6350
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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 2000163364 MO Primary

Addresses

Primary practice location

1010 Ste Genevieve Dr
Sainte Genevieve, MO 63670-1447

Mailing address

8821 US Highway 61
Sainte Genevieve, MO 63670-8563

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
2000163364MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1144691288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8821 US HIGHWAY 61",
            "city": "SAINTE GENEVIEVE",
            "state": "MO",
            "postal_code": "636708563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 STE GENEVIEVE DR",
            "city": "SAINTE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701447",
            "telephone_number": "573-883-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLERT",
        "first_name": "KELLY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2000163364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sainte Genevieve, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.