Individual provider Active NPI

Katherine Matthews

  • Occupational Therapy Assistant
  • Saint Louis, MO
National Provider Identifier
1215719257
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2020039757 Issued in MO
Practice address
3720 Hampton Ave Ste 102
Saint Louis, MO 63109-1438
Phone
(314) 833-8848
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2020039757 MO Primary

Addresses

Primary practice location

3720 Hampton Ave Ste 102
Saint Louis, MO 63109-1438

Mailing address

3407 S Jefferson Ave Ste 145
Saint Louis, MO 63118-3119

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
2020039757MOMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stride Therapy and Wellness LLC Occupational Therapy Assistant CurrentSince Oct 22, 2023 Accepting new patients

Locations

3407 S Jefferson Ave
Ste 145
Saint Louis, MO 63118
Phone (314) 833-8848

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1215719257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 S JEFFERSON AVE STE 145",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 HAMPTON AVE STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091438",
            "telephone_number": "314-833-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2020039757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.