Individual provider Active NPI

John Tengra, OTR

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1447429485
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
111065 Issued in TX
Practice address
130 Spencer LN
San Antonio, TX 78201-2109
Phone
(210) 733-9363
Fax
(210) 733-9383
NPI assigned
Feb 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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 111065 TX Primary

Addresses

Primary practice location

130 Spencer LN
San Antonio, TX 78201-2109

Mailing address

9898 Colonnade Blvd Apt 11204
San Antonio, TX 78230-2277
Phone (210) 641-7911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523001849 TX Practitioner - Occupational Therapist in Private Practice 5496197303 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111065TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Apr 16, 2024 Accepting new patients
Legacy Healthcare Services Inc. Occupational Therapist CurrentSince Apr 16, 2024 Accepting new patients
Fox Rehabilitation Services TX LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

4101 W Arkansas Ln
Arlington, TX 76016
Phone (817) 469-7671

6327 Cypresswood Dr
Spring, TX 77379
Phone (281) 374-1750

Organizations & group practices 3

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": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1447429485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9898 COLONNADE BLVD APT 11204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302277",
            "telephone_number": "210-641-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SPENCER LN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782012109",
            "telephone_number": "210-733-9363",
            "fax_number": "210-733-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENGRA",
        "first_name": "JOHN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "111065",
            "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 Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.