Individual provider Active NPI

Emma Grimes, COTA

  • Occupational Therapy Assistant
  • Addison, TX
National Provider Identifier
1447762539
Registry record updated Oct 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
211038 Issued in TX
Practice address
15820 Addison Rd
Addison, TX 75001-3549
Phone
(866) 919-3240
NPI assigned
Oct 29, 2017
Last updated
Oct 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2017

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 211038 TX Primary

Addresses

Primary practice location

15820 Addison Rd
Addison, TX 75001-3549

Mailing address

919 Dry Branch Rd
Forreston, TX 76041-2707
Phone (972) 921-5200

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
211038TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1509235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509235200000",
    "number": "1447762539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 DRY BRANCH RD",
            "city": "FORRESTON",
            "state": "TX",
            "postal_code": "760412707",
            "telephone_number": "972-921-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15820 ADDISON RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013549",
            "telephone_number": "866-919-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "EMMA",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-29",
        "last_updated": "2017-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2017; 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.