Active NPI
Katie Peacock, OTR
- Pediatric Occupational Therapist
- Allen, TX
National Provider Identifier
1063886299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 114614
- Practice address
- 800 N Watters Rd Ste 150
Allen, TX 75013-5395 - Phone
- (469) 675-3153
- Fax
- (469) 675-3154
- NPI assigned
- Nov 27, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 114614 | TX | |
| Pediatric Occupational Therapist | 225XP0200X | 114614 | TX | Primary |
Addresses
Primary practice location
800 N Watters Rd Ste 150
Allen, TX 75013-5395
Mailing address
800 N Watters Rd Ste 150
Allen, TX 75013-5395
Phone (469) 675-3153
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 |
|---|---|---|---|
| 114614 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cutting Edge Pediatric Therapy Houston, 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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Katy, TX
- NPI 1205236387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448582400000",
"number": "1063886299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 N WATTERS RD STE 150",
"city": "ALLEN",
"state": "TX",
"postal_code": "750135395",
"telephone_number": "469-675-3153",
"fax_number": "469-675-3154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 N WATTERS RD STE 150",
"city": "ALLEN",
"state": "TX",
"postal_code": "750135395",
"telephone_number": "469-675-3153",
"fax_number": "469-675-3154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "KATIE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-27",
"last_updated": "2015-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114614",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "114614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.