Individual provider Active NPI

Ellen M Dresbach, OTR/L

  • Occupational Therapist
  • Creve Coeur, MO
National Provider Identifier
1811136336
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2008022710 Issued in MO
Practice address
10560 Old Olive Street Rd
Suite 100
Creve Coeur, MO 63141-5916
Phone
(314) 567-4707
Fax
(314) 567-4505
NPI assigned
Feb 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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 2008022710 MO Primary

Addresses

Primary practice location

10560 Old Olive Street Rd
Suite 100
Creve Coeur, MO 63141-5916

Mailing address

5062 Lindenwood Ave
Unit a
Saint Louis, MO 63109-1727
Phone (603) 207-1693

Other names 1

  • Ellen M Green 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
2008022710MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1811136336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 LINDENWOOD AVE",
            "address_2": "UNIT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091727",
            "telephone_number": "603-207-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 OLD OLIVE STREET RD",
            "address_2": "SUITE 100",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415916",
            "telephone_number": "314-567-4707",
            "fax_number": "314-567-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRESBACH",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2008022710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "GREEN",
            "middle_name": "M",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.