Malissa Shull, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2006012395 Issued in MO

Practice address

801 NW Saint Mary Dr
Suite 220
Blue Springs, MO 64014-2524

Phone

(816) 220-3900

Fax

(816) 220-0877

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Affiliated Therapies of St Marys

  • Occupational Therapist
  • Blue Springs, MO
  • NPI 1063471738
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255463105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SE SUNNYSIDE SCHOOL CIR",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143679",
            "telephone_number": "816-220-3900",
            "fax_number": "816-220-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NW SAINT MARY DR",
            "address_2": "SUITE 220",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640142524",
            "telephone_number": "816-220-3900",
            "fax_number": "816-220-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "MALISSA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2006012395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "37008018",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheridan Emergency Physician Services of Missouri, Inc.
• Sheridan Healthcare of Missouri, Inc.
• Kathleen Shrum
• Ronald C Shrum, DDS
• Ronald Dale Shuey, DDS
• Shawna Sielert, LCPC, LMAC, LPC
• Silver Lining Counseling Services, LLC
• Kathryn C Simone, APRN
• Mikala Sims
• Pamela L. Sisk, APRN, BC

• Occupational Therapist in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.