Individual provider Active NPI

Sonja Stark, OTR

  • Occupational Therapist
  • Joplin, MO
National Provider Identifier
1962969055
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2019005140 Issued in MO
Practice address
201 S Northpark LN
Joplin, MO 64801-8426
Phone
(417) 622-4768
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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 2019005140 MO Primary

Addresses

Primary practice location

201 S Northpark LN
Joplin, MO 64801-8426

Mailing address

8216 County Road 166
Carthage, MO 64836-8628
Phone (417) 629-4797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422002358 MO Practitioner - Occupational Therapist in Private Practice 7810412830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019005140MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Key Rehabilitation, Inc CurrentSince Mar 11, 2025 Accepting new patients
Key Rehabilitation,Inc. Current Accepting new patients
Key Rehabilitation Inc Occupational Therapist CurrentSince Mar 11, 2025 Accepting new patients

Locations

620 N Jefferson St
Saint James, MO 65559
Phone (573) 265-0448

1335 NW Broad St
Murfreesboro, TN 37129
Phone (615) 983-0240

Organizations & group practices 3

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": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1962969055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8216 COUNTY ROAD 166",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648368628",
            "telephone_number": "417-629-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S NORTHPARK LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648018426",
            "telephone_number": "417-622-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "SONJA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2019005140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.