Michelle Payge Buckley, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2013028150 Issued in MO

Practice address

1300 S Main St
Clinton, MO 64735-2728

Phone

(660) 351-3185

NPI assigned

Sep 6, 2018

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 6, 2018.

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1396227286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W SUNDALE DR",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352732",
            "telephone_number": "660-351-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S MAIN ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352728",
            "telephone_number": "660-351-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MICHELLE",
        "middle_name": "PAYGE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2013028150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Currier Brown, M.D.
• Kimberly Kay Brown, COTA/L
• Michelle J Brown, FNP
• Denise Bruce
• Summer D Bryant, M.D.
• Anisa Ranay Burdick, FNP-C
• Ruby Bustamante, RBT
• Hailey Buttram, SLPA
• Dena Cambers
• Kathryn E. Camden, RN

• All providers in Clinton, MO
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.