NPIMap

Individual provider Active NPI

Kathleen Lillian Serfas, OTD,OTR/L

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1821393968
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2000155183 Issued in MO
Practice address
3437 Caroline St
Ahp, Room 2020
Saint Louis, MO 63104-1111
Phone
(314) 977-8582
NPI assigned
Jan 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2000155183 MO Primary
Occupational Therapist 225X00000X 056.008701 IL

Addresses

Primary practice location

3437 Caroline St
Ahp, Room 2020
Saint Louis, MO 63104-1111

Mailing address

5305 Fox CRST
Edwardsville, IL 62025-5739
Phone (573) 424-2092

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.008701ILMDOccupational Therapist
2000155183MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1821393968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 FOX CRST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620255739",
            "telephone_number": "573-424-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 CAROLINE ST",
            "address_2": "AHP, ROOM 2020",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041111",
            "telephone_number": "314-977-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERFAS",
        "first_name": "KATHLEEN",
        "middle_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "OTD,OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2000155183",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.008701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.