Active NPI
Chase Moder, OTR/L
- Occupational Therapist
- Independence, MO
National Provider Identifier
1174974158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2016016879
- Practice address
- 3980 South Jackson Dr
Independence, MO 64057 - Phone
- (816) 795-1433
- NPI assigned
- Jun 30, 2016
- 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 | 2016016879 | MO | Primary |
Addresses
Primary practice location
3980 South Jackson Dr
Independence, MO 64057
Mailing address
3980 South Jackson Drive
Independence, MO 64057
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 |
|---|---|---|---|
| 2016016879 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467244800000",
"number": "1174974158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3980 SOUTH JACKSON DRIVE",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "64057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3980 SOUTH JACKSON DR",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "64057",
"telephone_number": "816-795-1433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODER",
"first_name": "CHASE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-30",
"last_updated": "2016-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2016016879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
- Missouri Em-I Medical Services, P.C.
- Missouri Hospice Care, LLC (Missouri Palliative & Hospice Care)
- Missouri Palliative & Hospice Care Northwest LLC (Luminos Hospice)
- Mary Margaret Mitchell, MD
- Mobility First Inc
- Kiana Moffat
- Ambreen Mohamed, M.D.
- Tylan Mohler, CRNA
- Hamid Reza Molavi, PHARM-D
- Andrew C Monrad, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.