Individual provider Active NPI

Danielle Erica Agins, OTR/L

  • Occupational Therapist
  • Phoenix, AZ
National Provider Identifier
1205480894
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003684 Issued in AZ
Practice address
21630 N 19TH Ave
Phoenix, AZ 85027-2719
Phone
(602) 726-2300
NPI assigned
Jul 31, 2019
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 003684 AZ Primary

Addresses

Primary practice location

21630 N 19TH Ave
Phoenix, AZ 85027-2719

Mailing address

20701 N Scottsdale Rd # 107-487
Scottsdale, AZ 85255-6413
Phone (623) 606-0568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191230001627 AZ Practitioner - Occupational Therapist in Private Practice 4082048012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003684AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Occupational Therapist CurrentSince Oct 15, 2019 Accepting new patients
Achievement Therapy Services Past Accepting new patients
BHSM Rehabilitation, LLC PastSince Aug 6, 2019 Accepting new patients
Theracare PLLC Occupational Therapist PastSince Aug 6, 2019 Accepting new patients

Locations

21630 N 19th Ave
Ste B3
Phoenix, AZ 85027
Phone (602) 319-7324

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1205480894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20701 N SCOTTSDALE RD # 107-487",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852556413",
            "telephone_number": "623-606-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21630 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272719",
            "telephone_number": "602-726-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGINS",
        "first_name": "DANIELLE",
        "middle_name": "ERICA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "003684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.