Individual provider Active NPI

Dragan Petri, OT

  • Occupational Therapist
  • Alice, TX
National Provider Identifier
1407361124
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
117800 Issued in TX
Practice address
400 E Main St
Alice, TX 78332
Phone
(956) 233-4111
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 117800 TX Primary

Addresses

Primary practice location

400 E Main St
Alice, TX 78332

Mailing address

1006 W Whitney Ave
Louisville, KY 40215-2718

Other practice location 1

15820 Addison Rd
Addison, TX 75001-3549
Phone (214) 575-2999

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
117800TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Lighthouse Childrens Rehab Past Accepting new patients
Little Lighthouse Childrens Rehab Past Accepting new patients

Organizations & group practices 2

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": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1407361124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W WHITNEY AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402152718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E MAIN ST",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "78332",
            "telephone_number": "956-233-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15820 Addison Rd",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750013549",
            "country_code": "US",
            "telephone_number": "214-575-2999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRI",
        "first_name": "DRAGAN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alice, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.