Active NPI
Yaxuan Latham, OTR
- Occupational Therapist
- Fort Worth, TX
National Provider Identifier
1225849375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 123311
- Practice address
- 2501 Museum Way
Fort Worth, TX 76107-3058 - Phone
- (817) 632-3639
- NPI assigned
- Jan 17, 2025
- 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 | 123311 | TX | Primary |
Addresses
Primary practice location
2501 Museum Way
Fort Worth, TX 76107-3058
Mailing address
3456 Montego Bay LN
Fort Worth, TX 76123-2784
Phone (972) 505-8270
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 |
|---|---|---|---|
| 123311 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737072000000",
"number": "1225849375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3456 MONTEGO BAY LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761232784",
"telephone_number": "972-505-8270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 MUSEUM WAY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761073058",
"telephone_number": "817-632-3639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "YAXUAN",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-17",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "123311",
"primary": true
}
],
"identifiers": [],
"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 Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.