Individual provider Active NPI

Miracle Alyse Warren, OT

  • Occupational Therapist
  • Lawrence, KS
National Provider Identifier
1851093678
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3782 Issued in AR
Practice address
325 Maine St
Lawrence, KS 66044-1360
Phone
(785) 505-2712
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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
Occupational Therapist 225X00000X OTR3782 AR Primary

Addresses

Primary practice location

325 Maine St
Lawrence, KS 66044-1360

Mailing address

325 Maine St
Lawrence, KS 66044-1360
Phone (785) 505-2712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402001242 KS Practitioner - Occupational Therapist in Private Practice 0749703502 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SLPT LLCGroup PAC ID 1254764350, 6 clinicians

Practice addresses (Care Compare)

11036 Oakmont St
Overland Park, KS 66210-1100
Phone (913) 413-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR3782ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Missouri LLC Occupational Therapist CurrentSince Mar 20, 2025 Accepting new patients
Empowerme Rehabilitation Missouri LLC Occupational Therapist CurrentSince Mar 20, 2025 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Mar 20, 2025 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Mar 20, 2025 Accepting new patients
Kid Success, Inc. Past Accepting new patients

Locations

2700 Somerset Dr
Prairie Village, KS 66206
Phone (913) 276-0901

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1851093678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MAINE ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441360",
            "telephone_number": "785-505-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAINE ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441360",
            "telephone_number": "785-505-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MIRACLE",
        "middle_name": "ALYSE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.