Individual provider Active NPI

McKenzie Jade Crofford

  • Occupational Therapy Assistant
  • Willow Springs, MO
National Provider Identifier
1811804545
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2026011462 Issued in MO
Practice address
2240 County Road 1270
Willow Springs, MO 65793-3393
Phone
(573) 883-6761
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2026011462 MO Primary

Addresses

Primary practice location

2240 County Road 1270
Willow Springs, MO 65793-3393

Mailing address

2423 Covington MDWS
Poplar Bluff, MO 63901-2415
Phone (573) 707-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1811804545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 COVINGTON MDWS",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012415",
            "telephone_number": "573-707-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 COUNTY ROAD 1270",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933393",
            "telephone_number": "573-883-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFFORD",
        "first_name": "MCKENZIE",
        "middle_name": "JADE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2026011462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.