Individual provider Active NPI

Mya Rutledge, COTA

  • Occupational Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1588563647
Registry record updated Nov 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
219406 Issued in TX
Practice address
102 Palo Alto Rd Ste 120
San Antonio, TX 78211-3773
Phone
(210) 922-1785
NPI assigned
Nov 4, 2026
Last updated
Nov 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 219406 TX Primary

Addresses

Primary practice location

102 Palo Alto Rd Ste 120
San Antonio, TX 78211-3773

Mailing address

102 Palo Alto Rd Ste 120
San Antonio, TX 78211-3773
Phone (210) 922-1785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793750400000",
    "number": "1588563647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PALO ALTO RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113773",
            "telephone_number": "210-922-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PALO ALTO RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113773",
            "telephone_number": "210-922-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "MYA",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-11-04",
        "last_updated": "2026-11-04",
        "certification_date": "2026-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "219406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.