Individual provider Active NPI

Mariko Lighthart, OTR

  • Occupational Therapist
  • Chesterfield, MO
National Provider Identifier
1619018660
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2002030353 Issued in MO
Practice address
150 Long Rd Ste 150
Chesterfield, MO 63005-1237
Phone
(636) 733-3330
Fax
(636) 733-3332
NPI assigned
Feb 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2002030353 MO Primary

Addresses

Primary practice location

150 Long Rd Ste 150
Chesterfield, MO 63005-1237

Mailing address

150 Long Rd Ste 150
Chesterfield, MO 63005-1237
Phone (636) 733-3330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805000406 MO Practitioner - Occupational Therapist in Private Practice 5991187031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Society for the BlindGroup PAC ID 9739478439, 4 clinicians

Practice addresses (Care Compare)

8770 Manchester Rd
Saint Louis, MO 63144-2724
Phone (314) 968-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2002030353MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Louis Society for the Blind CurrentSince Aug 1, 2022 Accepting new patients
St. Louis Society for the Blind PastSince Aug 1, 2022 Accepting new patients

Locations

8770 Manchester Rd
Saint Louis, MO 63144
Phone (314) 968-9000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619018660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LONG RD STE 150",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051237",
            "telephone_number": "636-733-3330",
            "fax_number": "636-733-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 LONG RD STE 150",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051237",
            "telephone_number": "636-733-3330",
            "fax_number": "636-733-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTHART",
        "first_name": "MARIKO",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2002030353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.