Active NPI
Kendall Reynolds
- Occupational Therapy Assistant
- Jefferson City, MO
National Provider Identifier
1851153480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2018012512
- Practice address
- 315 E Dunklin St
Jefferson City, MO 65101-3128 - Phone
- (573) 659-3000
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2018012512 | MO | Primary |
Addresses
Primary practice location
315 E Dunklin St
Jefferson City, MO 65101-3128
Mailing address
5198 County Road 432
New Bloomfield, MO 65063-1310
Phone (573) 220-9402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018012512 | MO | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson City Public Schools | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Jefferson City, MO
- NPI 1801019906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1851153480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5198 COUNTY ROAD 432",
"city": "NEW BLOOMFIELD",
"state": "MO",
"postal_code": "650631310",
"telephone_number": "573-220-9402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 E DUNKLIN ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651013128",
"telephone_number": "573-659-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "KENDALL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-29",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MO",
"license": "2018012512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.