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NPI Code Detail

MEDICARE: MADISON RISTER OTA

MEDICARE: MADISON RISTER OTA
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
1224Z00000XOccupational Therapy Assistant2025027609MO

General Provider Information

NPI Number : 1346190089
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON RISTER OTA
Provider Business Mailing Address
First Line : 8477 S SUNCOAST BLVD
Second Line :
City : HOMOSASSA
State : FL
Zip : 34446-5028
Country : US
Telephone Number : 800-381-0822
Fax Number : 352-565-5201
Provider Business Practice Location Address
First Line : 1105 VILLAGE RD
Second Line :
City : NEOSHO
State : MO
Zip : 64850-9076
Country : US
Telephone Number : 800-381-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ MADISON RISTER OTA” Practice Location

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