Individual provider Active NPI

McKenzie Leigh Moninger, COTA

  • Pediatric Occupational Therapist
  • Allen, TX
National Provider Identifier
1134711468
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
216683 Issued in TX
Practice address
900 Junction Dr
Allen, TX 75013-5290
Phone
(469) 675-3153
NPI assigned
Feb 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 216683 TX Primary

Addresses

Primary practice location

900 Junction Dr
Allen, TX 75013-5290

Mailing address

532 Silver Maple Dr
Irving, TX 75063-4209
Phone (972) 824-3564

Other practice location 1

1707 Fountainview Dr
Mansfield, TX 76063-5091
Phone (817) 752-9662

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
216683TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cutting Edge Pediatric Therapy Multi-Specialty CurrentSince Feb 14, 2021 Accepting new patients

Locations

900 Junction Dr
Allen, TX 75013
Phone (469) 675-3153

1707 Fountainview Dr
Mansfield, TX 76063
Phone (817) 383-9088

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": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1134711468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 SILVER MAPLE DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750634209",
            "telephone_number": "972-824-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 JUNCTION DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135290",
            "telephone_number": "469-675-3153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 Fountainview Dr",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760635091",
            "country_code": "US",
            "telephone_number": "817-752-9662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONINGER",
        "first_name": "MCKENZIE",
        "middle_name": "LEIGH",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "216683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 8, 2021; 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.