Individual provider Active NPI

Laurie M Rich, O.T.

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1154485712
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
110930 Issued in TX
Practice address
3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277
Phone
(817) 569-4395
Fax
(817) 569-4517
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 110930 TX Primary
Pediatric Occupational Therapist 225XP0200X 110930 TX

Addresses

Primary practice location

3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277

Mailing address

3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277
Phone (817) 569-4395

Other identifiers 2

IdentifierTypeStateIssuer
159893001MedicaidTX
8T1853OtherTXBCBS

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
110930TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1154485712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "address_2": "HTN, CLIENT ACCOUNTING",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-569-4395",
            "fax_number": "817-569-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "address_2": "HTN, CLIENT ACCOUNTING",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-569-4395",
            "fax_number": "817-569-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "LAURIE",
        "middle_name": "M",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "110930",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "110930",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159893001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8T1853",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.