Melissa Deanne Fortmann, MOTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2003021891 Issued in MO

Practice address

678 S Commercial St
Harrisonville, MO 64701-1653

Phone

(816) 380-3325

Fax

(816) 380-3044

NPI assigned

Jan 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Melissa Deanne Martinez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1841595972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 S COMMERCIAL ST",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647011653",
            "telephone_number": "816-380-3325",
            "fax_number": "816-380-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTMANN",
        "first_name": "MELISSA",
        "middle_name": "DEANNE",
        "credential": "MOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-20",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-02184",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2003021891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MARTINEZ",
            "middle_name": "DEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.