Active NPI
Katelyn Rebecca Willingham, OTR
- Occupational Therapist
- Lubbock, TX
National Provider Identifier
1497386791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 120544
- Practice address
- 5225 S Loop 289 Ste 210
Lubbock, TX 79424-1319 - Phone
- (806) 780-4180
- NPI assigned
- Jan 27, 2020
- Sex
- Female
- 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 | 120544 | TX | Primary |
Addresses
Primary practice location
5225 S Loop 289 Ste 210
Lubbock, TX 79424-1319
Mailing address
420 Hyden Ave
Lubbock, TX 79416-4148
Phone (325) 212-9995
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 |
|---|---|---|---|
| 120544 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Health Services, Inc. | Past | Accepting new patients | |
| Epic Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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": "1580083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1497386791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 HYDEN AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794164148",
"telephone_number": "325-212-9995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 S LOOP 289 STE 210",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794241319",
"telephone_number": "806-780-4180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLINGHAM",
"first_name": "KATELYN",
"middle_name": "REBECCA",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-27",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "120544",
"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 Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.