Individual provider Active NPI

Jana Leigh Rothbauer, OTR

  • Occupational Therapist
  • Rockwall, TX
National Provider Identifier
1205153293
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107979 Issued in TX
Practice address
1944 N Lake Shore Dr
Rockwall, TX 75087-0350
Phone
(972) 772-4707
Fax
(469) 310-8856
NPI assigned
Apr 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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 107979 TX Primary
Pediatric Occupational Therapist 225XP0200X 107979 TX

Addresses

Primary practice location

1944 N Lake Shore Dr
Rockwall, TX 75087-0350

Mailing address

527 Christopher CT
Rockwall, TX 75032-8242
Phone (972) 772-4707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118001260 TX Practitioner - Occupational Therapist in Private Practice 4789073453 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107979TXMDSpeech-Language Pathologist

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": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1205153293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 CHRISTOPHER CT",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750328242",
            "telephone_number": "972-772-4707",
            "fax_number": "972-771-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 N LAKE SHORE DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750870350",
            "telephone_number": "972-772-4707",
            "fax_number": "469-310-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBAUER",
        "first_name": "JANA",
        "middle_name": "LEIGH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "107979",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "107979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.