Randi Elder
Individual provider Active NPI Occupational Therapist · Perryville, MO
NPI 1972996700 · NPPES record last updated Mar 18, 2015
Key facts
- NPI
- 1972996700
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 2014042823 (MO)
- Practice address
- 800 S Kingshighway St
Perryville, MO 63775-2106 - Phone
- (573) 547-6546
- NPI assigned
- Mar 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15937 | FL | MD | Occupational Therapist |
| 2014042823 | MO | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2014042823 | MO | Yes |
| Occupational Therapist | 225X00000X | 15937 | FL |
Addresses
Primary practice location
800 S Kingshighway St
Perryville, MO 63775-2106
Mailing address
707 Ridge Dr
Perryville, MO 63775-1427
Other providers in Perryville, MO
- Catherine Devaney
- Rachel Dibooglu
- Nicholas Patrick Doherty
- Shannon Lea Dreyer
- East Missouri Action Agency, Inc.
- Elite Spinal Chiropractic, LLC
- Empathic Care
- Shelby Lynne Erlacker
- Jenny Ernst
- Shay Elizabeth Ernst
All providers in Perryville, MO · Occupational Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.