Active NPI
Pamela Gardner
- Occupational Therapist
- Kirkwood, MO
National Provider Identifier
1891000998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 002798
- Practice address
- 1116 N Geyer Rd
Kirkwood, MO 63122-1134 - Phone
- (314) 596-6099
- NPI assigned
- Aug 12, 2010
- 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 Therapist | 225X00000X | 002798 | MO | Primary |
Addresses
Primary practice location
1116 N Geyer Rd
Kirkwood, MO 63122-1134
Mailing address
1116 N Geyer Rd
Kirkwood, MO 63122-1134
Phone (314) 596-6099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3149099698 | Medicaid | MO |
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 |
|---|---|---|---|
| 002798 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1891000998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 N GEYER RD",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631221134",
"telephone_number": "314-596-6099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 N GEYER RD",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631221134",
"telephone_number": "314-596-6099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "PAMELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-12",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "002798",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3149099698",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.