Active NPI
Mustard Seeds Therapy
- Pediatric Occupational Therapist
- Roanoke, TX
National Provider Identifier
1093135402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 107888
- 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, 2014
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107888 | Other | TX | OCCUPATIONAL THERAPY LICENSE NUMBER |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Social Worker
- Roanoke, TX
- NPI 1346688157
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.