Ashli Bourisaw, OTD

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

2024039444 Issued in MO

Practice address

3115 S Grand Blvd Ste 224
Saint Louis, MO 63118-1047

Phone

(314) 312-2375

NPI assigned

Sep 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1417775685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1689 YELLOW ROCK RD",
            "city": "DE SOTO",
            "state": "MO",
            "postal_code": "630204304",
            "telephone_number": "618-803-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 S GRAND BLVD STE 224",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181047",
            "telephone_number": "314-312-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURISAW",
        "first_name": "ASHLI",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MO",
            "license": "2024039444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis J Bouras, PA-C
• Christina Bourbon, M.ED, PLBA
• Raymond E Bourey, MD
• Brittney Bourgeois
• Nancy O Bourgeois, NP-C
• Amy Bourland, LCSW
• Steve Bourne, PH.D.
• Mary Lou Bourque, LPC
• Kelly B Bouse
• McKayla Bouse

• Pediatric Occupational Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.