Active NPI
Trena Sue Duckworth, MOT, OTR/L, CBIS
- Occupational Therapist
- Dallas, TX
National Provider Identifier
1508415076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 116830
- Practice address
- 909 N Washington Ave
Dallas, TX 75246-1520 - Phone
- (214) 820-9322
- Fax
- (214) 818-7990
- NPI assigned
- Sep 8, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 116830 | TX | Primary |
Addresses
Primary practice location
909 N Washington Ave
Dallas, TX 75246-1520
Mailing address
4277 County Road 1089
Celeste, TX 75423-4991
Phone (972) 658-5051
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 |
|---|---|---|---|
| 116830 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567900800000",
"number": "1508415076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4277 COUNTY ROAD 1089",
"city": "CELESTE",
"state": "TX",
"postal_code": "754234991",
"telephone_number": "972-658-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 N WASHINGTON AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752461520",
"telephone_number": "214-820-9322",
"fax_number": "214-818-7990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCKWORTH",
"first_name": "TRENA",
"middle_name": "SUE",
"credential": "MOT, OTR/L, CBIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-08",
"last_updated": "2019-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "116830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.