Individual provider Active NPI

Ladee Frakay Polk, O.T.R.

  • Pediatric Occupational Therapist
  • Desoto, TX
National Provider Identifier
1356472047
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
110553 Issued in TX
Practice address
1801 N Hampton Rd
Suite 350
Desoto, TX 75115-2391
Phone
(972) 230-0129
Fax
(972) 230-8247
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 110553 TX Primary

Addresses

Primary practice location

1801 N Hampton Rd
Suite 350
Desoto, TX 75115-2391

Mailing address

PO Box 693
Desoto, TX 75123-0693
Phone (972) 230-0129

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

LicenseStateTypeSpecialty
110553TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Just 4 Kidz Therapy, LLC Current Accepting new patients

Locations

1801 N Hampton Rd
Ste 350
Desoto, TX 75115
Phone (972) 230-0129

Organizations & group practices 1

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356472047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 693",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751230693",
            "telephone_number": "972-230-0129",
            "fax_number": "972-230-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N HAMPTON RD",
            "address_2": "SUITE 350",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152391",
            "telephone_number": "972-230-0129",
            "fax_number": "972-230-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "LADEE",
        "middle_name": "FRAKAY",
        "name_prefix": "Mrs.",
        "credential": "O.T.R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "110553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.