Active NPI
Teresa Phillips, OTR
- Occupational Therapist
- Lufkin, TX
National Provider Identifier
1033130877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104657
- Practice address
- 402 S John Redditt Dr
Lufkin, TX 75904-3107 - Phone
- (936) 632-2107
- Fax
- (936) 632-2108
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- 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 | 104657 | TX | Primary |
Addresses
Primary practice location
402 S John Redditt Dr
Lufkin, TX 75904-3107
Mailing address
402 S John Redditt Dr
Lufkin, TX 75904-3107
Phone (936) 632-2107
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104657 | Other | TX | OCCUP THERAPIST LIC # |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104657 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angelina Rehabilitation Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Lufkin, TX
- NPI 1912089962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278460800000",
"number": "1033130877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043107",
"telephone_number": "936-632-2107",
"fax_number": "936-632-2108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043107",
"telephone_number": "936-632-2107",
"fax_number": "936-632-2108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TERESA",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2010-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "104657",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUP THERAPIST LIC #",
"identifier": "104657",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
- Thanh-Diu Thi Pham, PA-C
- Courtney Michelle Phillips, FNP
- Marisa Jon Phillips, LPC/NCC
- Misty Rae Phillips, FNP
- Monica Lindsey Phillips, RDMS, RVT
- Phoenix Rising Behavioral Therapies PLLC (Phoenix Rising Behavioral Therapies)
- Physicians Medical Development Group PLLC
- Pickett Heart Clinic
- Amanda Dawn Pierce, FNP
- Piney Woods Healthcare System LP (Woodland Heights Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.