MEDICARE: DEREK SCHRICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	2018043184	MO

General Provider Information

NPI Number	:	1437715117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEREK SCHRICK

Provider Business Mailing Address
First Line	:	7727 NE 72ND TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-1229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 NE 72ND ST
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64119-7401
Country	:	US
Telephone Number	:	816-268-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2019
Last Update Date	:	05/17/2019

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