Individual provider Active NPI

Kaydee Alene Funkhouser, MS, OTR/L

  • Occupational Therapist
  • Florissant, MO
National Provider Identifier
1922336981
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2009030080 Issued in MO
Practice address
936 Charbonier Rd
Florissant, MO 63031-5220
Phone
(314) 831-4800
NPI assigned
Dec 1, 2009
Last updated
Dec 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2009030080 MO Primary

Addresses

Primary practice location

936 Charbonier Rd
Florissant, MO 63031-5220

Mailing address

936 Charbonier Rd
Florissant, MO 63031-5220
Phone (314) 831-4800

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2009030080MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1922336981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 CHARBONIER RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315220",
            "telephone_number": "314-831-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 CHARBONIER RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315220",
            "telephone_number": "314-831-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNKHOUSER",
        "first_name": "KAYDEE",
        "middle_name": "ALENE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2009030080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.