Individual provider Active NPI

Doungpan Phongpaichit, OTR

  • Occupational Therapist
  • Plano, TX
National Provider Identifier
1457466740
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
111926 Issued in TX
Practice address
1101 Ohio Drive
Suite 105
Plano, TX 75093
Phone
(972) 599-9594
Fax
(972) 599-9364
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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 111926 TX Primary

Addresses

Primary practice location

1101 Ohio Drive
Suite 105
Plano, TX 75093

Mailing address

1101 Ohio Drive
Suite 105
Plano, TX 75093
Phone (972) 599-9594

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080501000629 TX Practitioner - Occupational Therapist in Private Practice 2769561760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Hand Therapy PCGroup PAC ID 6204887383, 3 clinicians

Practice addresses (Care Compare)

1101 Ohio Dr
Suite 105
Plano, TX 75093-5331
Phone (972) 599-9594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111926TXMDOccupational Therapist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1457466740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 OHIO DRIVE",
            "address_2": "SUITE 105",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "972-599-9594",
            "fax_number": "972-599-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OHIO DRIVE",
            "address_2": "SUITE 105",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "972-599-9594",
            "fax_number": "972-599-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHONGPAICHIT",
        "first_name": "DOUNGPAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "111926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.