Alyssa Walters, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2018025618 Issued in MO

Practice address

12380 De Paul Dr
Bridgeton, MO 63044-2511

Phone

(314) 447-9710

NPI assigned

Jul 25, 2018

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 names 1

• Alyssa Haas Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• SSM Select Rehab St Louis LLC

  • Physical Medicine & Rehabilitation Physician
  • Richmond Heights, MO
  • NPI 1558403261
  NPD (past)

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1255818928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 PAPILLON DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622261048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 DE PAUL DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442511",
            "telephone_number": "314-447-9710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Arnold Mall",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630102223",
            "country_code": "US",
            "telephone_number": "636-282-0056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ALYSSA",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2018025618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "HAAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co
• Walgreen Co
• Walgreens Pharmacy
• Valerie O Walker, M.D.
• Christopher Waller
• Kongkeo Thiky Walther, ANP
• William Wang, M.D.
• Victoria Wannemuehler, MS, RDN, LD
• Waqar Ulislam Mirza MD
• Jeniffer Ane Washington

• Occupational Therapist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.