Individual provider Active NPI

Gloria Ann Brown, MS OTRL CHT

  • Hand Occupational Therapist
  • El Paso, TX
National Provider Identifier
1356300693
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
585 Issued in NM
Practice address
125 W Hague Rd Ste 310
El Paso, TX 79902-5806
Phone
(915) 996-3404
Fax
(915) 307-2331
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 585 NM Primary

Addresses

Primary practice location

125 W Hague Rd Ste 310
El Paso, TX 79902-5806

Mailing address

715 Frontier Dr
Las Cruces, NM 88011
Phone (505) 635-3963

Other names 1

  • Ms. Gloria Ann Rodakowski Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170121000286 TX Practitioner - Occupational Therapist in Private Practice 9133144942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3632NMMDMassage Therapist
585NMMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Hand Therapy Hand CurrentSince Oct 1, 2017 Accepting new patients
Real View Diagnostics LLC CurrentSince Jan 15, 2017 Accepting new patients
Ventana Therapy Center Limited PastSince Apr 28, 2005 Accepting new patients
Physiotherapy of El Paso, P.C. PastSince Jun 7, 2014 Accepting new patients

Locations

2404 S Locust St
Ste 5
Las Cruces, NM 88001
Phone (505) 521-4188

125 W Hague Rd
Ste 310
El Paso, TX 79902
Phone (208) 841-7818

550 S Mesa Hills Dr
Ste D3
El Paso, TX 79912
Phone (575) 635-3963

1845 Northwestern Dr
Ste B
El Paso, TX 79912
Phone (915) 875-1559

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1356300693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 FRONTIER DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "505-635-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W HAGUE RD STE 310",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025806",
            "telephone_number": "915-996-3404",
            "fax_number": "915-307-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GLORIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MS OTRL CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2021-11-15",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NM",
            "license": "585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "RODAKOWSKI",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.