Individual provider Active NPI

Trissa Berend

  • Occupational Therapy Assistant
  • Decatur, TX
National Provider Identifier
1518565712
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
605 W Mulberry St
Decatur, TX 76234-1263
Phone
(940) 733-6623
NPI assigned
Oct 12, 2020
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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 NU Primary

Addresses

Primary practice location

605 W Mulberry St
Decatur, TX 76234-1263

Mailing address

2094 Wolf Rd
Windthorst, TX 76389-4635
Phone (940) 733-6623

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL casamba

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

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1518565712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 WOLF RD",
            "city": "WINDTHORST",
            "state": "TX",
            "postal_code": "763894635",
            "telephone_number": "940-733-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W MULBERRY ST",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762341263",
            "telephone_number": "940-733-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREND",
        "first_name": "TRISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "casamba",
            "affiliation": "N",
            "address_1": "605 W Mulberry St",
            "city": "Decatur",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762341263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.