Individual provider Active NPI

Jodi Elaine Glosemeyer, OTR/L

  • Occupational Therapist
  • Washington, MO
National Provider Identifier
1790453116
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2021004886 Issued in MO
Practice address
840 W Pride Dr
Washington, MO 63090-1207
Phone
(636) 390-9150
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 2021004886 MO Primary

Addresses

Primary practice location

840 W Pride Dr
Washington, MO 63090-1207

Mailing address

16326 Concord Hill Rd
Marthasville, MO 63357-1999
Phone (636) 359-9997

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
2021004886MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1790453116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16326 CONCORD HILL RD",
            "city": "MARTHASVILLE",
            "state": "MO",
            "postal_code": "633571999",
            "telephone_number": "636-359-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W PRIDE DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630901207",
            "telephone_number": "636-390-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOSEMEYER",
        "first_name": "JODI",
        "middle_name": "ELAINE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2021004886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.