Individual provider Active NPI

Genelda Marie Alfred, OTR/L

  • Occupational Therapist
  • Humble, TX
National Provider Identifier
1265913677
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
110321 Issued in TX
Practice address
14949 Mesa Dr
Humble, TX 77396-2952
Phone
(281) 902-4152
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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 110321 TX Primary

Addresses

Primary practice location

14949 Mesa Dr
Humble, TX 77396-2952

Mailing address

14949 Mesa Dr
Humble, TX 77396-2952
Phone (281) 902-4152

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211029001899 TX Practitioner - Occupational Therapist in Private Practice 5294123907 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110321TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Sep 1, 2021 Accepting new patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince Apr 27, 2022 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Sep 1, 2021 Accepting new patients
Legacy Healthcare Services Inc. Occupational Therapist Current Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1265913677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14949 MESA DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773962952",
            "telephone_number": "281-902-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 MESA DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773962952",
            "telephone_number": "281-902-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFRED",
        "first_name": "GENELDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "110321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.