Individual provider Active NPI

Elizabeth Terry, COTA/L

  • Occupational Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1376201590
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216713 Issued in TX
Practice address
855 E Basse Rd
San Antonio, TX 78209-1890
Phone
(210) 910-2900
NPI assigned
Dec 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 216713 TX Primary

Addresses

Primary practice location

855 E Basse Rd
San Antonio, TX 78209-1890

Mailing address

6511 Candleview CT
San Antonio, TX 78244-1908

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
216713TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1376201590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 CANDLEVIEW CT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782441908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 E BASSE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091890",
            "telephone_number": "210-910-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ELIZABETH",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.