Active NPI
Andrea Juarez, OTD
- Occupational Therapist
- Springfield, MO
National Provider Identifier
1326657628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2020023044
- Practice address
- 1301 E Sunshine St
Springfield, MO 65804-1143 - Phone
- (417) 889-4800
- Fax
- (270) 215-4834
- NPI assigned
- Jul 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2020023044 | MO | Primary |
Addresses
Primary practice location
1301 E Sunshine St
Springfield, MO 65804-1143
Mailing address
1301 E Sunshine St
Springfield, MO 65804-1143
Phone (417) 889-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020023044 | Other | MO | STATE LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020023044 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595462400000",
"number": "1326657628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 E SUNSHINE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658041143",
"telephone_number": "417-889-4800",
"fax_number": "270-215-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 E SUNSHINE ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658041143",
"telephone_number": "417-889-4800",
"fax_number": "270-215-4834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "ANDREA",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-23",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2020023044",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2020023044",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.