Individual provider Active NPI

Timothy Alan Purviance, COTA

  • Occupational Therapy Assistant
  • Amarillo, TX
National Provider Identifier
1245445659
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
209125 Issued in TX
Practice address
5108 Pin Oak Dr
Amarillo, TX 79110-4625
Phone
(806) 463-7523
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 209125 TX Primary

Addresses

Primary practice location

5108 Pin Oak Dr
Amarillo, TX 79110-4625

Mailing address

PO Box 19914
Amarillo, TX 79114-1914
Phone (806) 463-7523

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
209125TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245445659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19914",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791141914",
            "telephone_number": "806-463-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 PIN OAK DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791104625",
            "telephone_number": "806-463-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURVIANCE",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "209125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.