Individual provider Active NPI

Minerva Desdemona Williams, COTA

  • Occupational Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1487134466
Registry record updated Aug 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
211407 Issued in TX
Practice address
1 Heartland Drive
San Antonio, TX 78247
Phone
(210) 653-1219
NPI assigned
Aug 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2018

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 211407 TX Primary

Addresses

Primary practice location

1 Heartland Drive
San Antonio, TX 78247

Mailing address

10326 Margarita Hill
Converse, TX 78109
Phone (321) 914-7726

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
211407TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1534550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534550400000",
    "number": "1487134466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10326 MARGARITA HILL",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "78109",
            "telephone_number": "321-914-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEARTLAND DRIVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78247",
            "telephone_number": "210-653-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MINERVA",
        "middle_name": "DESDEMONA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-18",
        "last_updated": "2018-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211407",
            "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 Aug 18, 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.