Britni J Wallach, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056011006 Issued in IL

Practice address

2061 Pear Tree CT
Apt 5
Cape Girardeau, MO 63701-2111

Phone

(618) 593-9218

Fax

(573) 472-0409

NPI assigned

Aug 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Britni J Carnako Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1689953531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 608",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638010608",
            "telephone_number": "573-472-0397",
            "fax_number": "573-472-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 PEAR TREE CT",
            "address_2": "APT 5",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012111",
            "telephone_number": "618-593-9218",
            "fax_number": "573-472-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "BRITNI",
        "middle_name": "J",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2011023399",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056011006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITNI",
            "last_name": "CARNAKO",
            "middle_name": "J",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wal-Mart Stores East, LP
• Walgreen Co
• Andrew Francis Walker, M.D.
• Kathy L Wallace, RNFA
• Sharon K Wallace, MD
• Katie Wallis, MS, ATC
• Dawn M Walston, MSN AHCNS, APRN-BC
• Carrie Dea Wamble, RD LD
• Muhammad A Waqas, MD
• Alexa Taylor Ward

• Occupational Therapist in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.