Individual provider Active NPI

Brian D Womack, OTR/L

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1326617507
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2021019009 Issued in MO
Practice address
4337 Butler Hill Rd Ste L
Saint Louis, MO 63128-3735
Phone
(314) 487-7000
Fax
(314) 487-7001
NPI assigned
Jun 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2021019009 MO Primary

Addresses

Primary practice location

4337 Butler Hill Rd Ste L
Saint Louis, MO 63128-3735

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723001444 MO Practitioner - Occupational Therapist in Private Practice 9436552700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1832 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone (636) 327-7110

229 S Stewart Rd
Suite E 3
Liberty, MO 64068-4206
Phone (816) 656-3695

3950 Vogel Rd
Arnold, MO 63010-3790
Phone (636) 461-0900

4337 Butler Hill Rd
Suite L
Saint Louis, MO 63128-3735
Phone (314) 487-7000

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021019009MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist Current Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

4337 Butler Hill Rd
Ste L
Saint Louis, MO 63128
Phone (314) 487-7000

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: brian.womack.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1326617507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4337 BUTLER HILL RD STE L",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283735",
            "telephone_number": "314-487-7000",
            "fax_number": "314-487-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2021019009",
            "primary": true
        }
    ],
    "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 Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.