Individual provider Active NPI

Joella Dawn McGrew, OT

  • Pediatric Occupational Therapist
  • Allen, TX
National Provider Identifier
1093073058
Registry record updated Apr 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
110078 Issued in TX
Practice address
515 W Main St
Suite 111
Allen, TX 75013-8000
Phone
(214) 509-6961
Fax
(214) 382-0943
NPI assigned
Apr 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 110078 TX Primary

Addresses

Primary practice location

515 W Main St
Suite 111
Allen, TX 75013-8000

Mailing address

515 W Main St
Suite 111
Allen, TX 75013-8000
Phone (214) 509-6961

Other names 1

  • Miss Joella Dawn Keith Former name

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

LicenseStateTypeSpecialty
110078TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Therapy Zone LLC Pediatrics 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.

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1093073058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W MAIN ST",
            "address_2": "SUITE 111",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138000",
            "telephone_number": "214-509-6961",
            "fax_number": "214-382-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W MAIN ST",
            "address_2": "SUITE 111",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138000",
            "telephone_number": "214-509-6961",
            "fax_number": "214-382-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGREW",
        "first_name": "JOELLA",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "110078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOELLA",
            "last_name": "KEITH",
            "middle_name": "DAWN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.