Individual provider Active NPI

Amy B Harrison, BS OTR

  • Pediatric Occupational Therapist
  • Lubbock, TX
National Provider Identifier
1467966077
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
109961 Issued in TX
Practice address
6502 Slide Rd Ste 204
Lubbock, TX 79424-1311
Phone
(806) 686-0429
NPI assigned
Nov 20, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 109961 TX Primary

Addresses

Primary practice location

6502 Slide Rd Ste 204
Lubbock, TX 79424-1311

Mailing address

6502 Slide Rd Ste 204
Lubbock, TX 79424-1311

Other practice location 1

1628 19th St
Lubbock, TX 79401-4832
Phone (806) 766-1000

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
109961TXMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467966077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 SLIDE RD STE 204",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794241311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 SLIDE RD STE 204",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794241311",
            "telephone_number": "806-686-0429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1628 19th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794014832",
            "country_code": "US",
            "telephone_number": "806-766-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "BS OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "109961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.