Active NPI
Jimmy Anthony Canales II, COTA
- Occupational Therapist
- Portland, TX
National Provider Identifier
1477034494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 213468
- Practice address
- 221 Cedar Dr
Portland, TX 78374-2900 - Phone
- (361) 643-1888
- NPI assigned
- Aug 27, 2018
- Last updated
- Aug 27, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 213468 | TX | Primary |
Addresses
Primary practice location
221 Cedar Dr
Portland, TX 78374-2900
Mailing address
6025 Natchez Dr
Corpus Christi, TX 78414-4164
Phone (361) 877-6411
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 |
|---|---|---|---|
| 213468 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535328000000",
"number": "1477034494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6025 NATCHEZ DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784144164",
"telephone_number": "361-877-6411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 CEDAR DR",
"city": "PORTLAND",
"state": "TX",
"postal_code": "783742900",
"telephone_number": "361-643-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANALES",
"first_name": "JIMMY",
"middle_name": "ANTHONY",
"name_suffix": "II",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-27",
"last_updated": "2018-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "213468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, TX
- Ora E Bruns
- Clarinda E. Buendia, PTA
- Harlan V Burhans, D.C.
- C H Wilkinson Physician Network (CHRISTUS Convenient Clinic)
- Ulysses G Cabanog, OT
- Juan Miguel Capupus, FNP-C
- Carriage Inn Limited Partnership (Carriage Inn)
- CC Doctors Center Portland, PLLC (The Doctors Center Urgent Care)
- Alyssa Marie Ceja, PHARMACY TECH
- Jesus Cervantes, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.