Antonio Maldonado, OTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2012026727 Issued in MO

Practice address

2017 W Woodland St
Springfield, MO 65807-5913

Phone

(417) 889-4800

Fax

(417) 889-0980

NPI assigned

Nov 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1205209939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W WOODLAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075913",
            "telephone_number": "417-889-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W WOODLAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075913",
            "telephone_number": "417-889-4800",
            "fax_number": "417-889-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "ANTONIO",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2012026727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Sail Enterprises-Downtown LLC (dba DOWNTOWN PHARMACY)
• Katelynn Main, DO
• Keith Edwin Mainprize, D.C.
• Taylor Majors, RN
• Vyacheslav I Makler, D.O.
• Perry D Maleare, CRNA
• Shelly Maledy-Martin, PLPC
• Elizabet Malinin, PHARMD
• Malkmus Chiropractic & Acupuncture
• Cole Thomas Malkmus, DC, MS

• Occupational Therapy Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.