Individual provider Active NPI

Laura Wettig, OTR/L

  • Occupational Therapist
  • Colleyville, TX
National Provider Identifier
1568945574
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
119402 Issued in TX
Practice address
4113 Gateway Dr Ste 200
Colleyville, TX 76034-5942
Phone
(817) 793-7764
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 119402 TX Primary

Addresses

Primary practice location

4113 Gateway Dr Ste 200
Colleyville, TX 76034-5942

Mailing address

120 Creekway BND
Southlake, TX 76092-9421
Phone (817) 584-2925

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
119402TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Child'S Play Pediatric Therapy, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1568945574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CREEKWAY BND",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929421",
            "telephone_number": "817-584-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 GATEWAY DR STE 200",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345942",
            "telephone_number": "817-793-7764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTIG",
        "first_name": "LAURA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "119402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.