NPIMap

Organization Active NPI

St. Nicholas Children's Therapies LLC

  • Occupational Therapist
  • Roeland Park, KS
National Provider Identifier
1285626937
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
ST. NICHOLAS CHILDREN'S THERAPIES LLC
Practice address
3811 W 52ND St
Roeland Park, KS 66205-1458
Phone
(913) 579-8556
Fax
(816) 763-1802
NPI assigned
Aug 18, 2005
Last updated
Dec 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Authorized official

Name
Deborah J Herzog, OTR/LNPI 1164428751
Title
Owber
Phone
(913) 579-8556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary
Pediatric Occupational Therapist 225XP0200X NU

Addresses

Primary practice location

3811 W 52ND St
Roeland Park, KS 66205-1458

Mailing address

3811 W 52ND St
Roeland Park, KS 66205-1458
Phone (913) 579-8556

Other practice location 1

1010 Carondelet Dr Ste 120
Kansas City, MO 64114-4843
Phone (913) 579-8556

Other identifiers 1

IdentifierTypeStateIssuer
34966016OtherMOBCBS OF KANSAS CITY GROUP

National Provider Directory

National Provider Directory

Locations

4804 Noland Rd
Ste O
Kansas City, MO 64133
Phone (816) 350-0514

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1285626937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 W 52ND ST",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662051458",
            "telephone_number": "913-579-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 W 52ND ST",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662051458",
            "telephone_number": "913-579-8556",
            "fax_number": "816-763-1802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Carondelet Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144843",
            "country_code": "US",
            "telephone_number": "913-579-8556",
            "fax_number": "816-763-1802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. NICHOLAS CHILDREN'S THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWBER",
        "authorized_official_telephone_number": "913-579-8556",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS CITY GROUP",
            "identifier": "34966016",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roeland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.