Active NPI
Marissa Kimberly Cohen, OTR/L
- Occupational Therapist
- Poplar Bluff, MO
National Provider Identifier
1366996795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2016025322
- Practice address
- 3390 Kanell Blvd
Poplar Bluff, MO 63901-3060 - Phone
- (573) 686-5439
- Fax
- (573) 472-0409
- NPI assigned
- Aug 15, 2016
- 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 | 2016025322 | MO | Primary |
Addresses
Primary practice location
3390 Kanell Blvd
Poplar Bluff, MO 63901-3060
Mailing address
3390 Kanell Blvd
Poplar Bluff, MO 63901
Phone (573) 686-5439
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2016025322 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1366996795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3390 KANELL BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "63901",
"telephone_number": "573-686-5439",
"fax_number": "573-472-0409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3390 KANELL BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639013060",
"telephone_number": "573-686-5439",
"fax_number": "573-472-0409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "MARISSA",
"middle_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2016025322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.