Individual provider Active NPI

Kae Lynn Blecha

  • Occupational Therapist
  • Hannibal, MO
National Provider Identifier
1194086215
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
001666 Issued in MO
Practice address
1734 Market St
Hannibal, MO 63401-4025
Phone
(573) 629-0321
NPI assigned
Jun 5, 2012
Last updated
Jun 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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 001666 MO Primary

Addresses

Primary practice location

1734 Market St
Hannibal, MO 63401-4025

Mailing address

1734 Market St
Hannibal, MO 63401-4025
Phone (573) 629-0321

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
001666MOMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1194086215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 MARKET ST",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634014025",
            "telephone_number": "573-629-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 MARKET ST",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634014025",
            "telephone_number": "573-629-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLECHA",
        "first_name": "KAE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "001666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.