Active NPI
Jason Faris, OTR
- Occupational Therapist
- Texarkana, TX
National Provider Identifier
1013327204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 111457
- Practice address
- 4100 Moores LN
Texarkana, TX 75503-5102 - Phone
- (903) 733-1557
- NPI assigned
- Apr 28, 2014
- Last updated
- Apr 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 111457 | TX | Primary |
Addresses
Primary practice location
4100 Moores LN
Texarkana, TX 75503-5102
Mailing address
4100 Moores LN
Texarkana, TX 75503-5102
Phone (903) 733-1557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111457 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398643200000",
"number": "1013327204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 MOORES LN",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755035102",
"telephone_number": "903-733-1557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 MOORES LN",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755035102",
"telephone_number": "903-733-1557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARIS",
"first_name": "JASON",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-28",
"last_updated": "2014-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "111457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
- Family Medical Group of Texarkana
- Family Practice of Texarkana PLLC (Texarkana Family Practice PA)
- Fannin County Hospital Authority (Avir at Citizens Trail)
- Fannin County Hospital Authority (Heritage Plaza Nursing Center)
- Fannin County Hospital Authority (Reunion Plaza Senior Care and Rehabilitation Center)
- Kennedy Brea Faulkenberry
- Fci Texarkana
- Betty J Feir, PH.D
- Richard L Fender, CRNA
- Christopher Alan Ferguson, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.