Individual provider Active NPI

Sierra Holzum, OTR/L

  • Occupational Therapist
  • Saint Peters, MO
National Provider Identifier
1780073999
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2013027848 Issued in MO
Practice address
617 Wyatt CT
Saint Peters, MO 63376-7175
Phone
(314) 210-4003
NPI assigned
Jan 12, 2015
Last updated
Jan 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-1425 HI
Occupational Therapist 225X00000X 2013027848 MO Primary
Occupational Therapist 225X00000X 116583 TX

Addresses

Primary practice location

617 Wyatt CT
Saint Peters, MO 63376-7175

Mailing address

617 Wyatt CT
Saint Peters, MO 63376-7175
Phone (314) 210-4003

Other names 1

  • Sierra Baechle Former name

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

LicenseStateTypeSpecialty
OT-1425HIMDOccupational Therapist
2013027848MOMDOccupational Therapist
116583TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1780073999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 WYATT CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767175",
            "telephone_number": "314-210-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 WYATT CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767175",
            "telephone_number": "314-210-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZUM",
        "first_name": "SIERRA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "HI",
            "license": "OT-1425",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2013027848",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIERRA",
            "last_name": "BAECHLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.