Individual provider Active NPI

Heidi Marie Wolfert, OTR

  • Physical Rehabilitation Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1992066542
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
2010016792 Issued in MO
Practice address
3908 Shenandoah Ave
Saint Louis, MO 63110-4016
Phone
(618) 201-1112
NPI assigned
May 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 2010016792 MO Primary
Physical Rehabilitation Occupational Therapist 225XP0019X 056006552 IL

Addresses

Primary practice location

3908 Shenandoah Ave
Saint Louis, MO 63110-4016

Mailing address

3908 Shenandoah Ave
Saint Louis, MO 63110-4016
Phone (618) 201-1112

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
056006552ILMDPhysical Rehabilitation Occupational Therapist
2010016792MOMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1992066542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 SHENANDOAH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104016",
            "telephone_number": "618-201-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 SHENANDOAH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104016",
            "telephone_number": "618-201-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFERT",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MO",
            "license": "2010016792",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "IL",
            "license": "056006552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.