Alexis Tatter

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105362 Issued in MN

Practice address

2407 Kentucky St
Louisiana, MO 63353-2503

Phone

(573) 754-5456

NPI assigned

Oct 5, 2018

Last updated

Oct 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapeutic Health and Home LLC

  • Physical Therapist
  • Eagle River, AK
  • NPI 1205421047
  Medicare reassignment NPD
• NSH Wausau LLC

  • Skilled Nursing Facility
  • Wausau, WI
  • NPI 1194243998
  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1386119303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19766 SAGO 3",
            "city": "WARBA",
            "state": "MN",
            "postal_code": "557931610",
            "telephone_number": "218-256-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 KENTUCKY ST",
            "city": "LOUISIANA",
            "state": "MO",
            "postal_code": "633532503",
            "telephone_number": "573-754-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATTER",
        "first_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "086494",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6247-26",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2018005948",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "OTP-OT-LIC-6137",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip W Pitney, MD
• Jennifer Marie Radcliff, BCBA
• Nancy Reid, LPC
• Heather Smith
• SSM Depaul Medical Group, Inc. (SSM Health Medical Group)
• Frank T Thomalla III, DDS
• Heather Treaster
• George Michael Vallar, DDS
• Susan T Voss, N.P.
• Jill Watts

• Occupational Therapist in Louisiana, MO
• Providers in Louisiana, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.