Active NPI
Georgia Denise Distefano, OTR
- Occupational Therapist
- Merriam, KS
National Provider Identifier
1770795619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1700373
- Practice address
- 6700 Antioch Ste 430
Merriam, KS 66204 - Phone
- (913) 652-9229
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 1700373 | KS | Primary |
Addresses
Primary practice location
6700 Antioch Ste 430
Merriam, KS 66204
Mailing address
19303 West 64TH Terrace
Shawnee, KS 66218
Phone (913) 962-9818
Other names 1
- Ms. Denise Distefano
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1700373 | KS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770795619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19303 WEST 64TH TERRACE",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "66218",
"telephone_number": "913-962-9818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 ANTIOCH STE 430",
"city": "MERRIAM",
"state": "KS",
"postal_code": "66204",
"telephone_number": "913-652-9229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISTEFANO",
"first_name": "GEORGIA",
"middle_name": "DENISE",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "1700373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DENISE",
"last_name": "DISTEFANO",
"prefix": "MS.",
"credential": "OTR",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Merriam, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.