Your Supportive Place LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

YOUR SUPPORTIVE PLACE LLC

Practice address

2551 Oakland Ave
Maplewood, MO 63143-1919

Phone

(314) 200-2610

Fax

(314) 353-9030

NPI assigned

Mar 2, 2022

Last updated

Oct 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jane Bufe, OTDNPI 1659028447

Title

Occupational Therapist

Phone

(314) 200-2610

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jane Bufe, OTD

  • Occupational Therapist
  • Maplewood, MO
  • NPI 1659028447
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1568119360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 OAKLAND AVE",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631431919",
            "telephone_number": "314-200-2610",
            "fax_number": "314-353-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 OAKLAND AVE",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631431919",
            "telephone_number": "314-200-2610",
            "fax_number": "314-353-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR SUPPORTIVE PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "BUFE",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "314-200-2610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTD"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP (Vision Center 30-5150)
• Joice Westfall-Hollingsworth, RN
• Benjamin Michael Wildman, MAT, ATC
• Jessica Lynn Woodruff, LCSW
• Kevin Woodruff

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.