Tara K Diggs, MORT/L

Individual provider Active NPI Occupational Therapist · Winfield, MO

NPI 1477046233 · NPPES record last updated Jan 24, 2022

Key facts

NPI
1477046233
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
2016004144 (MO)
Practice address
119 Beth Ann Dr
Winfield, MO 63389-2001
Phone
(573) 318-4365
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2016004144MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy 4 Kids LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X MO
Occupational Therapist 225X00000X 2016004144 MO Yes

Addresses

Primary practice location

119 Beth Ann Dr
Winfield, MO 63389-2001

Mailing address

119 Beth Ann Dr
Winfield, MO 63389-2001
Phone (573) 318-4365

Other identifiers

IdentifierTypeStateIssuer
1477046233MedicaidMO

Other providers in Winfield, MO

All providers in Winfield, MO · Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.