Active NPI
Traci Taylor, OTR
- Occupational Therapist
- Lindale, TX
National Provider Identifier
1174647895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 107905
- Practice address
- 2808 S Main St Ste C
Lindale, TX 75771-7854 - Phone
- (903) 780-6596
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 107905 | TX | Primary |
Addresses
Primary practice location
2808 S Main St Ste C
Lindale, TX 75771-7854
Mailing address
201 Karla Dr
Whitehouse, TX 75791-3903
Phone (903) 539-6994
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 |
|---|---|---|---|
| 107905 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bo Keeling, PLLC | Occupational Therapist | Past | Accepting new patients |
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": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652140800000",
"number": "1174647895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 KARLA DR",
"city": "WHITEHOUSE",
"state": "TX",
"postal_code": "757913903",
"telephone_number": "903-539-6994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2808 S MAIN ST STE C",
"city": "LINDALE",
"state": "TX",
"postal_code": "757717854",
"telephone_number": "903-780-6596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "TRACI",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2022-05-10",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "107905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lindale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.