Individual provider Active NPI

Kerry Parnell

  • Occupational Therapist
  • Springfield, MO
National Provider Identifier
1649758111
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2018007091 Issued in MO
Practice address
1610 E. Sunshine Street
Springfield, MO 65804
Phone
(417) 523-7500
NPI assigned
Aug 6, 2018
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 2018007091 MO Primary

Addresses

Primary practice location

1610 E. Sunshine Street
Springfield, MO 65804

Mailing address

1610 E. Sunshine Street
Springfield, MO 65804

Other names 1

  • Kerry Tinklepaugh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191010000791 KS Practitioner - Occupational Therapist in Private Practice 0143551812 Reassigns benefits to 1 organization
I20231205003777 MO Practitioner - Occupational Therapist in Private Practice 0143551812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018007091MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Sep 16, 2019 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Sep 16, 2019 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 3

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": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1649758111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 E. SUNSHINE STREET",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 E. SUNSHINE STREET",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-523-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARNELL",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2018007091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "TINKLEPAUGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.