Individual provider Active NPI

Brittni Amber Futrell

  • Occupational Therapist
  • O Fallon, IL
National Provider Identifier
1972161065
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2023011865 Issued in MO
Practice address
634 N Main St Ste 4
O Fallon, IL 62269-3746
Phone
(618) 726-5870
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Occupational Therapist 225X00000X 2023011865 MO Primary

Addresses

Primary practice location

634 N Main St Ste 4
O Fallon, IL 62269-3746

Mailing address

671 Springfield Dr
Wentzville, MO 63385-9082
Phone (636) 409-2650

Other practice location 1

634 N Main St Ste 4
O Fallon, IL 62269-3746
Phone (618) 726-5870

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

LicenseStateTypeSpecialty
2023011865MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1972161065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 SPRINGFIELD DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633859082",
            "telephone_number": "636-409-2650",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 N MAIN ST STE 4",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693746",
            "telephone_number": "618-726-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "634 N Main St Ste 4",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622693746",
            "country_code": "US",
            "telephone_number": "618-726-5870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUTRELL",
        "first_name": "BRITTNI",
        "middle_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2023011865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.