Individual provider Active NPI

Michelle Jeanne Dumbacher, OTR/L

  • Neurorehabilitation Occupational Therapist
  • Lakeway, TX
National Provider Identifier
1548521057
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
115808 Issued in TX
Practice address
2000 Medical Dr
Lakeway, TX 78734-4200
Phone
(512) 263-4500
Fax
(512) 263-4500
NPI assigned
May 31, 2012
Last updated
Apr 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 115808 TX Primary

Addresses

Primary practice location

2000 Medical Dr
Lakeway, TX 78734-4200

Mailing address

409 W Comanche Ave
Shabbona, IL 60550-9790
Phone (815) 824-2194

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
115808TXMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1548521057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W COMANCHE AVE",
            "city": "SHABBONA",
            "state": "IL",
            "postal_code": "605509790",
            "telephone_number": "815-824-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL DR",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344200",
            "telephone_number": "512-263-4500",
            "fax_number": "512-263-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMBACHER",
        "first_name": "MICHELLE",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "TX",
            "license": "115808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.