Individual provider Active NPI

Juana Betty Perez

  • Occupational Therapy Assistant
  • Edmond, OK
National Provider Identifier
1609560879
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2495 Issued in OK
Practice address
1505 Renaissance Blvd
Edmond, OK 73013-3018
Phone
(405) 850-8497
Fax
(405) 300-0643
NPI assigned
Jun 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 2495 OK Primary

Addresses

Primary practice location

1505 Renaissance Blvd
Edmond, OK 73013-3018

Mailing address

520 NW 92ND St
Oklahoma City, OK 73114-2902
Phone (405) 532-9572

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
2495OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Therapy, LLC Occupational Therapy Assistant PastSince Jun 11, 2023 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": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1609560879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 NW 92ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142902",
            "telephone_number": "405-532-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 RENAISSANCE BLVD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133018",
            "telephone_number": "405-850-8497",
            "fax_number": "405-300-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JUANA",
        "middle_name": "BETTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "2495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.