Individual provider Active NPI

Lauren Souders, MOTR/L, CBIS, CSRS

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1578847166
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2010027444 Issued in MO
Practice address
4455 Duncan Ave
Saint Louis, MO 63110-1111
Phone
(314) 658-3800
NPI assigned
Oct 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.009124 IL
Occupational Therapist 225X00000X 2010027444 MO Primary

Addresses

Primary practice location

4455 Duncan Ave
Saint Louis, MO 63110-1111

Mailing address

701 Bobwhite Cir
O Fallon, IL 62269-3108
Phone (618) 977-9426

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
056.009124ILMDOccupational Therapist
2010027444MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1317427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1578847166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BOBWHITE CIR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693108",
            "telephone_number": "618-977-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 DUNCAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101111",
            "telephone_number": "314-658-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDERS",
        "first_name": "LAUREN",
        "credential": "MOTR/L, CBIS, CSRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-01",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.009124",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2010027444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.