Active NPI
Amanda Genry Hatley
- Pediatric Occupational Therapist
- Dallas, TX
National Provider Identifier
1134302003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 111943
- Practice address
- 17480 N Dallas Pkwy
Ste 221
Dallas, TX 75287 - Phone
- (214) 623-5900
- NPI assigned
- Dec 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 111943 | TX | Primary |
Addresses
Primary practice location
17480 N Dallas Pkwy
Ste 221
Dallas, TX 75287
Mailing address
305 NE Loop 280; Business Tower 1, Suite 200
Hurst, TX 76053
Phone (843) 509-2443
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 |
|---|---|---|---|
| 111943 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1134302003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 280; BUSINESS TOWER 1, SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "76053",
"telephone_number": "843-509-2443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17480 N DALLAS PKWY",
"address_2": "STE 221",
"city": "DALLAS",
"state": "TX",
"postal_code": "75287",
"telephone_number": "214-623-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATLEY",
"first_name": "AMANDA",
"middle_name": "GENRY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-13",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "111943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.