Brenda Kay Thebeau

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

005389 Issued in MO

Practice address

3761 E US Highway 54
Linn Creek, MO 65052-1756

Phone

(314) 808-2955

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1225797129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3761 E US HIGHWAY 54",
            "city": "LINN CREEK",
            "state": "MO",
            "postal_code": "650521756",
            "telephone_number": "314-808-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3761 E US HIGHWAY 54",
            "city": "LINN CREEK",
            "state": "MO",
            "postal_code": "650521756",
            "telephone_number": "314-808-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEBEAU",
        "first_name": "BRENDA",
        "middle_name": "KAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "005389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles J. McMullin Jr., M.D.
• Alison Meinecke, MS, PLPC
• Ria Newcomb, LPC
• Anita Pinson, LPC, RPT
• Coralee Prettyman
• Kenzi L Turpin-Miller, LPC, CRAADC, PHD
• Aaron Wheeler

• Occupational Therapy Assistant in Linn Creek, MO
• Providers in Linn Creek, 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 Dec 8, 2021; 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.