Katheryn Kelly Maddox, OTR L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

005250 Issued in MO

Practice address

525 N Keene St
Suite 101
Columbia, MO 65201-6967

Phone

(573) 882-7350

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1831267897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 GRANT LN",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652030652",
            "telephone_number": "573-819-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N KEENE ST",
            "address_2": "SUITE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016967",
            "telephone_number": "573-882-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "KATHERYN",
        "middle_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "OTR L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "005250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474003928",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gavin Christopher Mackie, MD
• Jane Elizabeth Maclellan, RPH
• Markandeya Madabattula
• Nicholas Madaffer, D.O.
• Grace Maddox
• Andres Madrid, MD
• Tinashe Maduke, MD, MPH
• Paula Magalhaes-Barton
• Joseph David Magee III, M.D.
• Reggie Eugene Maggard, CRNA

• Occupational Therapist in Columbia, MO
• Providers in Columbia, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.