Jaqueline Maria Shafer

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

005080 Issued in MO

Practice address

105 Bonnybridge CT
Ellisville, MO 63021-4507

Phone

(314) 914-5000

NPI assigned

Jul 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bella Living LLC

  • Environmental Modification Occupational Therapist
  • Ellisville, MO
  • NPI 1821508102
  NPD Authorized official

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508380171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BONNYBRIDGE CT",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "63021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BONNYBRIDGE CT",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214507",
            "telephone_number": "314-914-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "JAQUELINE",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "005080",
            "primary": true
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "MO",
            "license": "005080",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Sarlone, MPT
• David Brian Schaller, D.C.
• Beth E Schobel, RPH
• Carol Schwartz, PT
• Mary-Ashley Seabrook, PLPC, SEP-IT
• Sheahan Eagan Family Care LLC
• Melissa Sheahan, D.C.
• Steve Paul Sigman, PHYSICIAN ASSISTANT
• Alexandra Sigmund
• Jordan H Silk

• Occupational Therapist in Ellisville, MO
• Providers in Ellisville, 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 21, 2022; 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.