Active NPI
Joyce Marie Kallenberger
- Occupational Therapist
- Weatherby Lake, MO
National Provider Identifier
1669030755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2004011316
- Practice address
- 8200 NW Weatherby Dr
Weatherby Lake, MO 64152-1596 - Phone
- (816) 694-5494
- NPI assigned
- Jun 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2004011316 | MO | Primary |
Addresses
Primary practice location
8200 NW Weatherby Dr
Weatherby Lake, MO 64152-1596
Mailing address
8200 NW Weatherby Dr
Weatherby Lake, MO 64152-1596
Phone (816) 694-5494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2004011316 | Other | MO | DIVISION OF PROFESSIONAL REGISTRATION |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1669030755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8200 NW WEATHERBY DR",
"city": "WEATHERBY LAKE",
"state": "MO",
"postal_code": "641521596",
"telephone_number": "816-694-5494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 NW WEATHERBY DR",
"city": "WEATHERBY LAKE",
"state": "MO",
"postal_code": "641521596",
"telephone_number": "816-694-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALLENBERGER",
"first_name": "JOYCE",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-03",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2004011316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIVISION OF PROFESSIONAL REGISTRATION",
"identifier": "2004011316",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weatherby Lake, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.