Avery Rosina Pacella, MOT R/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2020038276 Issued in MO

Practice address

884 Woods Mill Rd Ste 200
Ballwin, MO 63011-3657

Phone

(636) 238-4910

NPI assigned

Nov 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1144823436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 HIGHLANDS PLAZA DR APT 335",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 WOODS MILL RD STE 200",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113657",
            "telephone_number": "636-238-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACELLA",
        "first_name": "AVERY",
        "middle_name": "ROSINA",
        "credential": "MOT R/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.013944",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2020038276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "PracticePro",
            "affiliation": "N",
            "endpointDescription": "Health Documenting System",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "884 Woods Mill Rd Ste 200",
            "city": "Ballwin",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630113657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.