Individual provider Active NPI

Tireka Vonsha Hobson, OT

  • Occupational Therapist
  • Cordova, TN
National Provider Identifier
1023173564
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2812 Issued in TN
Practice address
1536 Appling Care LN
Cordova, TN 38016-4927
Phone
(901) 385-1803
NPI assigned
Dec 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2812 TN Primary

Addresses

Primary practice location

1536 Appling Care LN
Cordova, TN 38016-4927

Mailing address

95 Mossy Springs Dr
Oakland, TN 38060-3492
Phone (901) 412-7619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216001016 TN Practitioner - Occupational Therapist in Private Practice 9032502034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

6420 Quince Rd
Memphis, TN 38119-8227
Phone (901) 883-0358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2812TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients
Ave Maria Home CurrentSince Feb 7, 2022 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

2805 Charles Bryan Rd
Bartlett, TN 38134
Phone (901) 386-3211

6420 Quince Rd
Memphis, TN 38119
Phone (901) 883-0358

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023173564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MOSSY SPRINGS DR",
            "city": "OAKLAND",
            "state": "TN",
            "postal_code": "380603492",
            "telephone_number": "901-412-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 APPLING CARE LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380164927",
            "telephone_number": "901-385-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBSON",
        "first_name": "TIREKA",
        "middle_name": "VONSHA",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "2812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.