Active NPI
Traci Peters Royal, OTR
- Occupational Therapist
- San Antonio, TX
National Provider Identifier
1447339007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 109144
- Practice address
- 85 NE Loop 410
Suite 209
San Antonio, TX 78216-5829 - Phone
- (210) 340-2627
- Fax
- (210) 340-6437
- NPI assigned
- Nov 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 109144 | TX | Primary |
Addresses
Primary practice location
85 NE Loop 410
Suite 209
San Antonio, TX 78216-5829
Mailing address
8719 Sagebrush LN
San Antonio, TX 78217-5836
Phone (210) 826-9929
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8T1334 | Other | TX | BLUE CROSS BLUE SHEILD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109144 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Treehouse Pediatric Center | Occupational Therapist | Past | Accepting new patients |
| Treehouse Behavioral Services | 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.
-
- Developmental - Behavioral Pediatrics Physician
- San Antonio, TX
- NPI 1437228582
-
- Developmental - Behavioral Pediatrics Physician
- San Antonio, TX
- NPI 1982773198
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447339007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8719 SAGEBRUSH LN",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782175836",
"telephone_number": "210-826-9929",
"fax_number": "210-340-6437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 NE LOOP 410",
"address_2": "SUITE 209",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782165829",
"telephone_number": "210-340-2627",
"fax_number": "210-340-6437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYAL",
"first_name": "TRACI",
"middle_name": "PETERS",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "109144",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "8T1334",
"state": "TX"
}
],
"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 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.