Individual provider Active NPI

Monica Gorman Varner, COTA

  • Occupational Therapy Assistant
  • Creve Coeur, MO
National Provider Identifier
1972641173
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2006002516 Issued in MO
Practice address
10560 Old Olive Street Rd
Suite 100
Creve Coeur, MO 63141-5916
Phone
(314) 567-4707
Fax
(314) 567-4505
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2006002516 MO Primary

Addresses

Primary practice location

10560 Old Olive Street Rd
Suite 100
Creve Coeur, MO 63141-5916

Mailing address

9118 Eager Rd
Saint Louis, MO 63144-1121
Phone (979) 574-7839

Other identifiers 1

IdentifierTypeStateIssuer
1114090792OtherMOGROUP NPI NUMBER

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
2006002516MOMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972641173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9118 EAGER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441121",
            "telephone_number": "979-574-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 OLD OLIVE STREET RD",
            "address_2": "SUITE 100",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415916",
            "telephone_number": "314-567-4707",
            "fax_number": "314-567-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNER",
        "first_name": "MONICA",
        "middle_name": "GORMAN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2006002516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1114090792",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.