Charles Edgar Averill Jr., O.T.R. L.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2006013588 Issued in MO

Practice address

704A South Missouri
Macon, MO 63552

Phone

(660) 385-2500

NPI assigned

Nov 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Skip Averill Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477624161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 MANOR CREST DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013356",
            "telephone_number": "660-627-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704A SOUTH MISSOURI",
            "city": "MACON",
            "state": "MO",
            "postal_code": "63552",
            "telephone_number": "660-385-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERILL",
        "first_name": "CHARLES",
        "middle_name": "EDGAR",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "O.T.R. L.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2006013588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SKIP",
            "last_name": "AVERILL",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Advanced Medical Equipment, Inc
• Adrian Neil Agustin, P.T.
• Janet C Ancell, OTR
• Cicilia Ariga
• Melissa Ausmus, RDH
• Cynthia R. Ayers, L.P.C.
• Krystal Barnett
• Rogelio L Bautista, M.D.
• Keith Alan Beauchamp, D.P.M.
• Shelley Eileen Beckley, LCSW

• Occupational Therapist in Macon, MO
• Providers in Macon, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.