Individual provider Active NPI

Jordan Reddin, OTR/L

  • Occupational Therapist
  • Florissant, MO
National Provider Identifier
1508449877
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2020037214 Issued in MO
Practice address
3501 Dunn Rd Ste 108
Florissant, MO 63033-6762
Phone
(314) 972-8070
NPI assigned
May 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2020037214 MO Primary

Addresses

Primary practice location

3501 Dunn Rd Ste 108
Florissant, MO 63033-6762

Mailing address

3501 Dunn Rd Ste 108
Florissant, MO 63033-6762

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
2020037214MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1508449877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 DUNN RD STE 108",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 DUNN RD STE 108",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336762",
            "telephone_number": "314-972-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDIN",
        "first_name": "JORDAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2020037214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.