Individual provider Active NPI

Mary Jane Weiss

  • Pediatric Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1225454127
Registry record updated Mar 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
101219 Issued in TX
Practice address
11933 Mission Trace St
San Antonio, TX 78230-2123
Phone
(210) 690-8650
NPI assigned
Mar 15, 2014
Last updated
Mar 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 101219 TX Primary

Addresses

Primary practice location

11933 Mission Trace St
San Antonio, TX 78230-2123

Mailing address

11933 Mission Trace St
San Antonio, TX 78230-2123
Phone (210) 690-8650

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
101219TXMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1394841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394841600000",
    "number": "1225454127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11933 MISSION TRACE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302123",
            "telephone_number": "210-690-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11933 MISSION TRACE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302123",
            "telephone_number": "210-690-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "MARY",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-15",
        "last_updated": "2014-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "101219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2014; 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.