Individual provider Active NPI

Michael Bender, OT

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1770512246
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
004823 Issued in MO
Practice address
5240 Oakland Ave # a
Saint Louis, MO 63110-1436
Phone
(314) 291-9900
Fax
(314) 291-9909
NPI assigned
Jun 30, 2006
Last updated
Dec 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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 004823 MO Primary

Addresses

Primary practice location

5240 Oakland Ave # a
Saint Louis, MO 63110-1436

Mailing address

11469 Olive Blvd
#116
Creve Coeur, MO 63141-7108
Phone (314) 291-9900

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

State licenses

LicenseStateTypeSpecialty
004823MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Specialties Inc CurrentSince Feb 9, 2000 Accepting new patients
Advanced Neuro Rehab LLC Past Accepting new patients
House Call Doctors, LLC PastSince Apr 30, 2003 Accepting new patients

Locations

11469 Olive Blvd
Saint Louis, MO 63141
Phone (314) 200-5851

5240 Oakland Ave
#A
Saint Louis, MO 63110
Phone (314) 291-9900

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1770512246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11469 OLIVE BLVD",
            "address_2": "#116",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417108",
            "telephone_number": "314-291-9900",
            "fax_number": "314-291-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 OAKLAND AVE # A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101436",
            "telephone_number": "314-291-9900",
            "fax_number": "314-291-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "MICHAEL",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "004823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.