Bethany Tackett, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

122054 Issued in TX

Practice address

3000 Joe Dimaggio Blvd Ste 56
Round Rock, TX 78665-3996

Phone

(512) 218-6955

NPI assigned

Oct 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Footsteps and Handprints Pediatric Therapy, LLC

  • Pediatric Physical Therapist
  • Round Rock, TX
  • NPI 1104114412
  NPD

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1275296709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10430 MORADO CIR APT 2012",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595669",
            "telephone_number": "785-302-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 JOE DIMAGGIO BLVD STE 56",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653996",
            "telephone_number": "512-218-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "BETHANY",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "122054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph M Szczytowski, DO
• Deborah June Taber, MA, LPC
• Borna Ethan Tabibian, MD
• Jorge Luis Taboada, M.D.
• Gayle Tabotabo
• Amal Tahir, RBT
• Taj Healthcare, LLC
• Temitope Talabi, PHARMD
• Ameriah Taleb
• Nafee Tahmidul Talukder, DO

• Occupational Therapist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.