Healthcare Provider Details

I. General information

NPI: 1225955313
Provider Name (Legal Business Name): HANNAH SHOEMAKER COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2673 E SAWYER RD
REPUBLIC MO
65738-7574
US

IV. Provider business mailing address

2864 S NETTLETON AVE
SPRINGFIELD MO
65807-5970
US

V. Phone/Fax

Practice location:
  • Phone: 417-605-7100
  • Fax: 417-708-0889
Mailing address:
  • Phone: 417-605-7168
  • Fax: 417-708-0889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2021031648
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: