NPIMap

Organization Active NPI

Bella Living LLC

  • Environmental Modification Occupational Therapist
  • Ellisville, MO
National Provider Identifier
1821508102
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational TherapistTaxonomy code 225XE0001X
License
005080 Issued in MO
Legal business name
BELLA LIVING LLC
Practice address
105 Bonnybridge CT
Ellisville, MO 63021-4507
Phone
(314) 914-5000
NPI assigned
Oct 2, 2017
Last updated
Oct 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Authorized official

Name
Mrs. Jaqueline Maria Shafer, OTR/LNPI 1508380171
Title
Occupational Therapist
Phone
(314) 914-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 005080 MO
Ergonomics Occupational Therapist 225XE1200X 005080 MO
Pediatric Occupational Therapist 225XP0200X 005080 MO
Gerontology Occupational Therapist 225XG0600X 005080 MO
Physical Rehabilitation Occupational Therapist 225XP0019X 005080 MO
Environmental Modification Occupational Therapist 225XE0001X 005080 MO Primary

Addresses

Primary practice location

105 Bonnybridge CT
Ellisville, MO 63021-4507

Mailing address

105 Bonnybridge CT
Ellisville, MO 63021-4507
Phone (314) 914-5000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1821508102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BONNYBRIDGE CT",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214507",
            "telephone_number": "314-914-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BONNYBRIDGE CT",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630214507",
            "telephone_number": "314-914-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "JAQUELINE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "314-914-5000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "005080",
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "MO",
            "license": "005080",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MO",
            "license": "005080",
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "MO",
            "license": "005080",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MO",
            "license": "005080",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "MO",
            "license": "005080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.