Individual provider Active NPI

Deborah L Bua, MOT

  • Occupational Therapist
  • Raytown, MO
National Provider Identifier
1386779973
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2006011923 Issued in MO
Practice address
10801 E State Route 350
Raytown, MO 64138-2367
Phone
(816) 737-5502
Fax
(816) 737-5504
NPI assigned
Feb 22, 2007
Last updated
Jun 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2006011923 MO Primary
Occupational Therapist 225X00000X 17-01557 KS

Addresses

Primary practice location

10801 E State Route 350
Raytown, MO 64138-2367

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (816) 226-4011

Other identifiers 4

IdentifierTypeStateIssuer
MA4370075OtherMOMEDICARE PTAN
KA2868053OtherKSMEDICARE PTAN
477599906MedicaidMO
46002038OtherBCBS-KC

Other names 1

  • Deborah L Rowland Former name

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

LicenseStateTypeSpecialty
17-01557KSMDOccupational Therapist
2006011923MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1386779973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "816-226-4011",
            "fax_number": "816-524-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 E STATE ROUTE 350",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641382367",
            "telephone_number": "816-737-5502",
            "fax_number": "816-737-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUA",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2006011923",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-01557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA4370075",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA2868053",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "477599906",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-KC",
            "identifier": "46002038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "ROWLAND",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raytown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.