Individual provider Active NPI

Roberta Marie Garza

  • Occupational Therapy Assistant
  • Sun City West, AZ
National Provider Identifier
1114758984
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-004971 Issued in AZ
Practice address
14515 W Granite Valley Dr
Sun City West, AZ 85375-6021
Phone
(623) 975-8000
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X OTA-004971 AZ Primary

Addresses

Primary practice location

14515 W Granite Valley Dr
Sun City West, AZ 85375-6021

Mailing address

10133 Sherrill Blvd Ste 200
Knoxville, TN 37932-3347
Phone (865) 392-2865

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
OTA-004971AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1114758984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10133 SHERRILL BLVD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379323347",
            "telephone_number": "865-392-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14515 W GRANITE VALLEY DR",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853756021",
            "telephone_number": "623-975-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "ROBERTA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-004971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.