Individual provider Active NPI

Brittany Nicole Diaz

  • Occupational Therapist
  • Phoenix, AZ
National Provider Identifier
1518217355
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009441 Issued in AZ
Practice address
21045 N 9TH PL Ste 204
Phoenix, AZ 85024-5635
Phone
(602) 726-2300
NPI assigned
Sep 19, 2012
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 117679 TX
Occupational Therapist 225X00000X 009441 AZ Primary
Speech-Language Pathologist 235Z00000X 37126 TX

Addresses

Primary practice location

21045 N 9TH PL Ste 204
Phoenix, AZ 85024-5635

Mailing address

2009 Mermaid Dr.
El Paso, TX 79936
Phone (915) 637-1676

Other practice location 1

10450 Brian Mooney Ave
El Paso, TX 79935-2809
Phone (915) 598-6616

Other identifiers 3

IdentifierTypeStateIssuer
149984001MedicaidTX
189296MedicaidAZ
207164901MedicaidTX

Other names 1

  • Brittany Alonzo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191125002797 TX Practitioner - Occupational Therapist in Private Practice 4486087806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117679TXMDSocial Worker
009441AZMDOccupational Therapist
37126TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
T3 Inc., LLC Occupational Therapist CurrentSince Jan 21, 2023 Accepting new patients
Theraplay4Kidz, LLC Occupational Therapist PastSince Sep 1, 2020 Accepting new patients

Locations

14476 Horizon Blvd
#B1
Horizon City, TX 79928
Phone (915) 999-8746

14476 Horizon Blvd
Ste 2
Horizon City, TX 79928
Phone (915) 999-8746

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1518217355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 MERMAID DR.",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79936",
            "telephone_number": "915-637-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21045 N 9TH PL STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850245635",
            "telephone_number": "602-726-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10450 Brian Mooney Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799352809",
            "country_code": "US",
            "telephone_number": "915-598-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117679",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "009441",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "37126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189296",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "ALONZO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.