Active NPI
Heather Reynolds, COTA
- Occupational Therapy Assistant
- Liberty, MO
National Provider Identifier
1396367835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2017029123
- Practice address
- 1200 W College St
Liberty, MO 64068-1036 - Phone
- (816) 781-3020
- NPI assigned
- May 6, 2020
- Last updated
- May 6, 2020
- 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 Therapy Assistant | 224Z00000X | 2017029123 | MO | Primary |
Addresses
Primary practice location
1200 W College St
Liberty, MO 64068-1036
Mailing address
6140 NW Union Chapel Rd
Parkville, MO 64152-1240
Phone (816) 686-4284
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other |
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 |
|---|---|---|---|
| 2017029123 | MO | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588723200000",
"number": "1396367835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6140 NW UNION CHAPEL RD",
"city": "PARKVILLE",
"state": "MO",
"postal_code": "641521240",
"telephone_number": "816-686-4284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W COLLEGE ST",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640681036",
"telephone_number": "816-781-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "HEATHER",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-06",
"last_updated": "2020-05-06",
"certification_date": "2020-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MO",
"license": "2017029123",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
"affiliation": "N",
"endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "800 Concourse Pkwy S Ste 200",
"city": "Maitland",
"state": "FL",
"country_code": "US",
"postal_code": "327516148",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.