NPIMap

Organization Active NPI

Outreach Occupational Therapy LLC

  • Rehabilitation Practitioner
  • Joplin, MO
National Provider Identifier
1740916451
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
OUTREACH OCCUPATIONAL THERAPY LLC
Practice address
223 W 3Rd St Ste a
Joplin, MO 64801-2512
Phone
(417) 850-5437
Fax
(888) 214-3770
NPI assigned
Jul 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Karen McColloughNPI 1922336460
Title
Member Manager
Phone
(417) 684-7415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

223 W 3Rd St Ste a
Joplin, MO 64801-2512

Mailing address

PO Box F
Nevada, MO 64772-0935
Phone (417) 684-7415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240206003539 MO Part B Supplier - Clinic/Group Practice 3577906635 Receives reassigned benefits from 1 practitioner
Practice locations: Joplin, MO

National Provider Directory

National Provider Directory

Locations

223 W 3rd St
Ste A
Joplin, MO 64801
Phone (417) 850-5437

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1740916451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX F",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647720935",
            "telephone_number": "417-684-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W 3RD ST STE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648012512",
            "telephone_number": "417-850-5437",
            "fax_number": "888-214-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH OCCUPATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-26",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "MCCOLLOUGH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "417-684-7415"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.