Individual provider Active NPI

Angelica Araceli Goodrich, OTR/L

  • Occupational Therapist
  • Versailles, MO
National Provider Identifier
1669095980
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2020010011 Issued in MO
Practice address
1101 W Clay Rd # 1177
Versailles, MO 65084-1177
Phone
(573) 378-5411
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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 2020010011 MO Primary

Addresses

Primary practice location

1101 W Clay Rd # 1177
Versailles, MO 65084-1177

Mailing address

44 Highway Z
Eldon, MO 65026-4817
Phone (785) 893-3305

Other practice location 1

640 Northwind Dr
Nixa, MO 65714-7708
Phone (785) 893-3305

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210513001851 MO Practitioner - Occupational Therapist in Private Practice 6507275005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physical Therapy PCGroup PAC ID 9335190339, 27 clinicians

Practice addresses (Care Compare)

1101 W Clay Rd
Lowr Level
Versailles, MO 65084-1177
Phone (877) 870-4976

1700 Morningside Dr
Chillicothe, MO 64601-1545
Phone (877) 870-4976

1926 Oak St
Unionville, MO 63565-1180
Phone (977) 870-4976

3333 W 10TH St
Mid America Physical Therapy
Sedalia, MO 65301-2113
Phone (877) 870-4976

610 Hwy O
Gravois Mills, MO 65037-6221
Phone (877) 870-4976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Physical Therapy, PC CurrentSince Jan 1, 2023 Accepting new patients
Lake Regional Health System PastSince May 24, 2020 Accepting new patients

Locations

3333 W 10th St
Sedalia, MO 65301
Phone (573) 256-2777

1101 W Clay Rd
#1177
Versailles, MO 65084
Phone (573) 378-5411

1101 W Clay Rd
Lowr
Versailles, MO 65084

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1669095980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HIGHWAY Z",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650264817",
            "telephone_number": "785-893-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W CLAY RD # 1177",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841177",
            "telephone_number": "573-378-5411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Northwind Dr",
            "address_purpose": "LOCATION",
            "city": "Nixa",
            "state": "MO",
            "postal_code": "657147708",
            "country_code": "US",
            "telephone_number": "785-893-3305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "ANGELICA",
        "middle_name": "ARACELI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-06-05",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2020010011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.