Active NPI
John Nieland
- Occupational Therapist
- Florissant, MO
National Provider Identifier
1154947976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2020006961
- Practice address
- 3501 Dunn Rd Ste 108
Florissant, MO 63033-6762 - Phone
- (314) 972-8070
- NPI assigned
- Jun 17, 2020
- Sex
- Male
- 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 | 2020006961 | MO | Primary |
Addresses
Primary practice location
3501 Dunn Rd Ste 108
Florissant, MO 63033-6762
Mailing address
4252 Botanical Ave FL 2
Saint Louis, MO 63110-3521
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 |
|---|---|---|---|
| 2020006961 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592352000000",
"number": "1154947976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4252 BOTANICAL AVE FL 2",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631103521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 DUNN RD STE 108",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630336762",
"telephone_number": "314-972-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELAND",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-17",
"last_updated": "2020-06-17",
"certification_date": "2020-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2020006961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.