Individual provider Active NPI

Scott Mundt, OTR

  • Occupational Therapist
  • Lufkin, TX
National Provider Identifier
1417978248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
109802 Issued in TX
Practice address
216 N John Redditt Dr
Lufkin, TX 75904-2620
Phone
(936) 632-2107
Fax
(936) 632-2108
NPI assigned
Jul 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 109802 TX Primary

Addresses

Primary practice location

216 N John Redditt Dr
Lufkin, TX 75904-2620

Mailing address

216 N John Redditt Dr
Lufkin, TX 75904-2620
Phone (936) 632-2107

Other identifiers 1

IdentifierTypeStateIssuer
109802OtherTXOCCUP THERAPIST LIC #

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
109802TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Angelina Rehabilitation Center, LLC PastSince Jan 17, 2005 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417978248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759042620",
            "telephone_number": "936-632-2107",
            "fax_number": "936-632-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759042620",
            "telephone_number": "936-632-2107",
            "fax_number": "936-632-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDT",
        "first_name": "SCOTT",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "109802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUP THERAPIST LIC #",
            "identifier": "109802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.