NPIMap

Organization Active NPI

Pediatric Place, LLC

  • Occupational Therapy Assistant
  • Clinton, MO
National Provider Identifier
1821979295
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Legal business name
PEDIATRIC PLACE, LLC
Practice address
210 S 2ND St Ste a
Clinton, MO 64735-2172
Phone
(660) 885-2394
Fax
(660) 383-1650
NPI assigned
Sep 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
Emma Wilt, OTA
Title
Occupational Therapist Assistant
Phone
(660) 885-2394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X Primary

Addresses

Primary practice location

210 S 2ND St Ste a
Clinton, MO 64735-2172

Mailing address

210 S 2ND St Ste a
Clinton, MO 64735-2172
Phone (660) 885-2394

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Place LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1821979295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 2ND ST STE A",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352172",
            "telephone_number": "660-885-2394",
            "fax_number": "660-383-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 2ND ST STE A",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352172",
            "telephone_number": "660-885-2394",
            "fax_number": "660-383-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "WILT",
        "authorized_official_first_name": "EMMA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "660-885-2394",
        "authorized_official_credential": "OTA"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.