Individual provider Active NPI

Ellen C Niles, OT

  • Occupational Therapist
  • Warrensburg, MO
National Provider Identifier
1356613434
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2001019333 Issued in MO
Practice address
1300 Veterans Rd
Warrensburg, MO 64093-8294
Phone
(573) 581-1088
Fax
(573) 581-5356
NPI assigned
Feb 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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 2001019333 MO Primary

Addresses

Primary practice location

1300 Veterans Rd
Warrensburg, MO 64093-8294

Mailing address

PO Box 383
Warsaw, MO 65355-0383
Phone (573) 581-1088

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
2001019333MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1356613434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653550383",
            "telephone_number": "573-581-1088",
            "fax_number": "573-581-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 VETERANS RD",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640938294",
            "telephone_number": "573-581-1088",
            "fax_number": "573-581-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILES",
        "first_name": "ELLEN",
        "middle_name": "C",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2001019333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.