Active NPI
Harry Bloodworth
- Occupational Therapy Assistant
- Longview, TX
National Provider Identifier
1255812061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 212450
- Practice address
- 2711 Pine Tree Rd
Longview, TX 75604-1646 - Phone
- (903) 759-3994
- NPI assigned
- Aug 29, 2018
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | 212450 | TX | Primary |
Addresses
Primary practice location
2711 Pine Tree Rd
Longview, TX 75604-1646
Mailing address
2711 Pine Tree Rd
Longview, TX 75604-1646
Phone (903) 759-3994
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 |
|---|---|---|---|
| 212450 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1255812061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2711 PINE TREE RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756041646",
"telephone_number": "903-759-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2711 PINE TREE RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756041646",
"telephone_number": "903-759-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOODWORTH",
"first_name": "HARRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "212450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.