Individual provider Active NPI

Alexis Marie Renfro, OTR/L

  • Occupational Therapist
  • Kansas City, KS
National Provider Identifier
1407607963
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17-03845 Issued in KS
Practice address
2300 N 113TH Ter
Kansas City, KS 66109-3786
Phone
(785) 571-3802
NPI assigned
Apr 1, 2024
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 17-03845 KS Primary

Addresses

Primary practice location

2300 N 113TH Ter
Kansas City, KS 66109-3786

Mailing address

348 W Jefferson St
Gardner, KS 66030-1193
Phone (785) 571-3802

Other names 1

  • Alexis Marie Streeter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412003836 KS Practitioner - Occupational Therapist in Private Practice 7719326560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis Health Group LLCGroup PAC ID 4284022203, 16 clinicians

Practice addresses (Care Compare)

10034 W 151St St
Overland Park, KS 66221-9326
Phone (816) 809-1085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Apr 1, 2024 Accepting new patients
Ellis Health Group LLC Occupational Therapist CurrentSince Jun 10, 2024 Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

10034 W 151st St
Overland Park, KS 66221
Phone (816) 799-1767

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1407607963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 W JEFFERSON ST",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "660301193",
            "telephone_number": "785-571-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N 113TH TER",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661093786",
            "telephone_number": "785-571-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFRO",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-03845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "STREETER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.