Active NPI
Mallory Knoblauch
- Occupational Therapist
- Colwich, KS
National Provider Identifier
1992224273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4868
- Practice address
- 16633 W 45TH St N
Colwich, KS 67030-9455 - Phone
- (316) 208-6084
- NPI assigned
- Sep 18, 2017
- Last updated
- Apr 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4868 | SC | Primary |
Addresses
Primary practice location
16633 W 45TH St N
Colwich, KS 67030-9455
Mailing address
16633 W 45TH St N
Colwich, KS 67030-9455
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4868 | SC | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1992224273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16633 W 45TH ST N",
"city": "COLWICH",
"state": "KS",
"postal_code": "670309455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16633 W 45TH ST N",
"city": "COLWICH",
"state": "KS",
"postal_code": "670309455",
"telephone_number": "316-208-6084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOBLAUCH",
"first_name": "MALLORY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-18",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "4868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colwich, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.