Active NPI
Cathy S Sullivan, COTA
- Occupational Therapy Assistant
- Saint James, MO
National Provider Identifier
1801166913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 005095
- Practice address
- 620 N Jefferson St
Saint James, MO 65559-1926 - Phone
- (573) 265-3271
- Fax
- (573) 265-0243
- NPI assigned
- Jan 5, 2012
- Last updated
- Jan 5, 2012
- 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 Therapy Assistant | 224Z00000X | 005095 | MO | Primary |
Addresses
Primary practice location
620 N Jefferson St
Saint James, MO 65559-1926
Mailing address
PO Box 383
Warsaw, MO 65355
Phone (800) 385-3978
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 |
|---|---|---|---|
| 005095 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325721600000",
"number": "1801166913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 383",
"city": "WARSAW",
"state": "MO",
"postal_code": "65355",
"telephone_number": "800-385-3978",
"fax_number": "660-438-6943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N JEFFERSON ST",
"city": "SAINT JAMES",
"state": "MO",
"postal_code": "655591926",
"telephone_number": "573-265-3271",
"fax_number": "573-265-0243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CATHY",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-05",
"last_updated": "2012-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MO",
"license": "005095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint James, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.