Individual provider Active NPI

Anthony Dewayne Townsend, COTA/L

  • Occupational Therapy Assistant
  • Saint Louis, MO
National Provider Identifier
1326309873
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2010015742 Issued in MO
Practice address
1265 McLaran Ave
Saint Louis, MO 63147-1606
Phone
(314) 388-4121
Fax
(314) 395-3103
NPI assigned
May 31, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2010015742 MO Primary
Occupational Therapy Assistant 224Z00000X 057.003235 IL

Addresses

Primary practice location

1265 McLaran Ave
Saint Louis, MO 63147-1606

Mailing address

4153 Washington Blvd
Saint Louis, MO 63108-3134
Phone (314) 315-2264

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
057.003235ILMDOccupational Therapy Assistant
2010015742MOMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1326309873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4153 WASHINGTON BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083134",
            "telephone_number": "314-315-2264",
            "fax_number": "314-652-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 MCLARAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631471606",
            "telephone_number": "314-388-4121",
            "fax_number": "314-395-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSEND",
        "first_name": "ANTHONY",
        "middle_name": "DEWAYNE",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-31",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2010015742",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.003235",
            "primary": false
        }
    ],
    "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 May 31, 2012; 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.