Organization Active NPI

Mustard Seeds Therapy

  • Pediatric Occupational Therapist
  • Roanoke, TX
National Provider Identifier
1093135402
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
107888 Issued in TX
Legal business name
MUSTARD SEEDS THERAPY
Practice address
212 N. Oak Street
Roanoke, TX 76262
Phone
(817) 541-7770
NPI assigned
Apr 24, 2014
Last updated
Apr 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Mrs. Crystal D Turner, OTR
Title
Occupational Therapist
Phone
(817) 541-7770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 107888 TX Primary

Addresses

Primary practice location

212 N. Oak Street
Roanoke, TX 76262

Mailing address

212 N. Oak Street
Roanoke, TX 76262
Phone (817) 541-7770

Other identifiers 1

IdentifierTypeStateIssuer
107888OtherTXOCCUPATIONAL THERAPY LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

212 N Oak St
Roanoke, TX 76262
Phone (817) 541-7770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1093135402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N. OAK STREET",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-541-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N. OAK STREET",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-541-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTARD SEEDS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "817-541-7770",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "107888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LICENSE NUMBER",
            "identifier": "107888",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.