Mallory Knoblauch
Individual provider Active NPI Occupational Therapist · Colwich, KS
NPI 1992224273 · NPPES record last updated Apr 11, 2018
Key facts
- NPI
- 1992224273
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4868 (SC)
- Practice address
- 16633 W 45TH St N
Colwich, KS 67030-9455 - Phone
- (316) 208-6084
- NPI assigned
- Sep 18, 2017
- 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 |
|---|---|---|---|
| 4868 | SC | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4868 | SC | Yes |
Addresses
Primary practice location
16633 W 45TH St N
Colwich, KS 67030-9455
Mailing address
16633 W 45TH St N
Colwich, KS 67030-9455
NPI Registry JSON
{
"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
- Kansas Post Acute Medical Services 1 PA
- Alexandria Kennedy
- William Kerschen
- April Kickhaefer
- Janie Kirby
- Nicholas Leonard Kraus
- Lauren Kretsch
- Breanna Langston
- Erin Laughlin
- Kaitlynn Lawrence
All providers in Colwich, KS · Occupational Therapist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2018. 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.