Individual provider Active NPI

Marchall Rena Hambrick, C.O.T.A./L

  • Occupational Therapy Assistant
  • Kansas City, MO
National Provider Identifier
1457606733
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2004023159 Issued in MO
Practice address
11515 Troost Ave
Kansas City, MO 64131-3769
Phone
(816) 943-0101
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2004023159 MO Primary
Occupational Therapy Assistant 224Z00000X 18-00668 KS

Addresses

Primary practice location

11515 Troost Ave
Kansas City, MO 64131-3769

Mailing address

5641 Euclid Ave
Kansas City, MO 64130-3333
Phone (816) 359-1529

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

LicenseStateTypeSpecialty
18-00668KSMDOccupational Therapy Assistant
2004023159MOMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1457606733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5641 EUCLID AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641303333",
            "telephone_number": "816-359-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 TROOST AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641313769",
            "telephone_number": "816-943-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBRICK",
        "first_name": "MARCHALL",
        "middle_name": "RENA",
        "name_prefix": "Mrs.",
        "credential": "C.O.T.A./L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2004023159",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "18-00668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.