Individual provider Active NPI

Elizabeth S. Minor, MOT

  • Pediatric Occupational Therapist
  • Hannibal, MO
National Provider Identifier
1205542594
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
2023000222 Issued in MO
Practice address
150 Medical Dr
Hannibal, MO 63401-6877
Phone
(573) 248-5777
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 2023000222 MO Primary

Addresses

Primary practice location

150 Medical Dr
Hannibal, MO 63401-6877

Mailing address

PO Box 551
Hannibal, MO 63401-0551
Phone (573) 248-5403

Other practice location 1

401 Business Highway 36
Monroe City, MO 63456-1351
Phone (573) 735-4632

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
2023000222MOMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1205542594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634010551",
            "telephone_number": "573-248-5403",
            "fax_number": "573-248-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-248-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Business Highway 36",
            "address_purpose": "LOCATION",
            "city": "Monroe City",
            "state": "MO",
            "postal_code": "634561351",
            "country_code": "US",
            "telephone_number": "573-735-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINOR",
        "first_name": "ELIZABETH",
        "middle_name": "S.",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MO",
            "license": "2023000222",
            "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 Jan 30, 2023; 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.