Active NPI
Mary Taber, OTR
- Occupational Therapist
- Ellisville, MO
National Provider Identifier
1851436281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 000591
- Practice address
- 15834 Clayton Rd
Ellisville, MO 63011-2212 - Phone
- (636) 227-2339
- Fax
- (636) 227-8711
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225X00000X | 000591 | MO | Primary |
Addresses
Primary practice location
15834 Clayton Rd
Ellisville, MO 63011-2212
Mailing address
670 Twigwood Dr
Ballwin, MO 63021-6328
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 |
|---|---|---|---|
| 000591 | MO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Park Early Intervention Center | 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.
-
- Voluntary or Charitable Agency
- Fenton, MO
- NPI 1396739124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851436281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 TWIGWOOD DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630216328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15834 CLAYTON RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112212",
"telephone_number": "636-227-2339",
"fax_number": "636-227-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABER",
"first_name": "MARY",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "000591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.