Active NPI
Kim Gomez, OTR
- Pediatric Occupational Therapist
- Plano, TX
National Provider Identifier
1275710048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 103994
- Practice address
- 4121 McClary Dr
Plano, TX 75093-6646 - Phone
- (972) 612-0374
- NPI assigned
- Jan 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 103994 | TX | Primary |
Addresses
Primary practice location
4121 McClary Dr
Plano, TX 75093-6646
Mailing address
4121 McClary Dr
Plano, TX 75093-6646
Phone (972) 612-0374
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 |
|---|---|---|---|
| 103994 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1275710048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 MCCLARY DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750936646",
"telephone_number": "972-612-0374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4121 MCCLARY DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750936646",
"telephone_number": "972-612-0374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "KIM",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-23",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "103994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.