Individual provider Active NPI

Jessica Gonzalez, COTA

  • Occupational Therapy Assistant
  • Rio Grande City, TX
National Provider Identifier
1518446608
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
211359 Issued in TX
Practice address
5346 East Highway 83 Unit 2 Building a
Rio Grande City, TX 78582-7858
Phone
(956) 317-1282
Fax
(956) 317-1291
NPI assigned
Aug 9, 2018
Last updated
Aug 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 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 211359 TX Primary

Addresses

Primary practice location

5346 East Highway 83 Unit 2 Building a
Rio Grande City, TX 78582-7858

Mailing address

420 Siria St
Sullivan City, TX 78595-2088
Phone (956) 424-2634

Other practice location 1

3346 W US Highway 83
Rio Grande City, TX 78582-6252
Phone (956) 352-1302

Other practice location 2

6 W Lincoln Avenue
Roma, TX 78584-7858
Phone (956) 847-4209

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
211359TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1518446608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SIRIA ST",
            "city": "SULLIVAN CITY",
            "state": "TX",
            "postal_code": "785952088",
            "telephone_number": "956-424-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5346 EAST HIGHWAY 83 UNIT 2 BUILDING A",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785827858",
            "telephone_number": "956-317-1282",
            "fax_number": "956-317-1291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3346 W US Highway 83",
            "address_purpose": "LOCATION",
            "city": "Rio Grande City",
            "state": "TX",
            "postal_code": "785826252",
            "country_code": "US",
            "telephone_number": "956-352-1302",
            "fax_number": "956-352-1303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 W Lincoln Avenue",
            "address_purpose": "LOCATION",
            "city": "Roma",
            "state": "TX",
            "postal_code": "785847858",
            "country_code": "US",
            "telephone_number": "956-847-4209",
            "fax_number": "956-847-4332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JESSICA",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.