Active NPI
Junction of Function Inc
- Pediatric Occupational Therapist
- Plano, TX
National Provider Identifier
1013171768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 7324
- Legal business name
- JUNCTION OF FUNCTION INC
- Practice address
- 2102 Promontory PT
Plano, TX 75075-3547 - Phone
- (239) 777-4009
- Fax
- (972) 612-6804
- NPI assigned
- Jul 11, 2008
- Organization subpart
- Yes
- Parent organization
- JUNCTION OF FUNCTION INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Kelly Ann Wilk, OTR L
- Title
- Occupational Therapist
- Phone
- (239) 777-4009
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 7324 | FL | Primary |
Addresses
Primary practice location
2102 Promontory PT
Plano, TX 75075-3547
Mailing address
2102 Promontory PT
Plano, TX 75075-3547
Phone (239) 777-4009
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 886525600 | Medicaid | FL | |
| 2823296 | Medicaid | TX |
National Provider Directory
National Provider Directory- Part of
- Junction of Function Inc
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Plano, TX
- NPI 1801962683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1379289600000",
"number": "1013171768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2102 PROMONTORY PT",
"city": "PLANO",
"state": "TX",
"postal_code": "750753547",
"telephone_number": "239-777-4009",
"fax_number": "972-612-6804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 PROMONTORY PT",
"city": "PLANO",
"state": "TX",
"postal_code": "750753547",
"telephone_number": "239-777-4009",
"fax_number": "972-612-6804"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JUNCTION OF FUNCTION INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JUNCTION OF FUNCTION INC",
"enumeration_date": "2008-07-11",
"last_updated": "2013-09-16",
"status": "A",
"authorized_official_last_name": "WILK",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
"authorized_official_telephone_number": "239-777-4009",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "OTR L"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "7324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "886525600",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2823296",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.