Individual provider Active NPI

Camille Boisvert Ko

  • Occupational Therapist
  • Dallas, TX
National Provider Identifier
1639560089
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
116669 Issued in TX
Practice address
8390 Lyndon B Johnson Fwy Ste 1000
Dallas, TX 75243-1288
Phone
(214) 750-9977
Fax
(214) 750-9983
NPI assigned
Feb 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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 116669 TX Primary

Addresses

Primary practice location

8390 Lyndon B Johnson Fwy Ste 1000
Dallas, TX 75243-1288

Mailing address

305 NE Loop 820
Business Tower 1, Suite 200
Hurst, TX 76053-7209
Phone (817) 292-8787

Other practice location 1

930 W Centerville Rd
#930c
Garland, TX 75041-5823
Phone (972) 303-7021

Other names 1

  • Camille Boisvert Jones Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260210000917 TX Practitioner - Occupational Therapist in Private Practice 8921587981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8390 Lyndon B Johnson Fwy
Suite 1000
Dallas, TX 75243

8440 Walnut Hill LN
Suite 800
Dallas, TX 75231-3825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116669TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Mar 1, 2025 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2025 Accepting new patients
Epic Pediatric Therapy, LP. Past Accepting new patients
Texas Health Physicians Group Past Accepting new patients

Locations

8390 Lyndon B Johnson Fwy
Ste 1000
Dallas, TX 75243
Phone (214) 750-9977

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

Organizations & group practices 4

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": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1639560089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE LOOP 820",
            "address_2": "BUSINESS TOWER 1, SUITE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760537209",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 LYNDON B JOHNSON FWY STE 1000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752431288",
            "telephone_number": "214-750-9977",
            "fax_number": "214-750-9983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 W Centerville Rd",
            "address_2": "#930c",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750415823",
            "country_code": "US",
            "telephone_number": "972-303-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KO",
        "first_name": "CAMILLE",
        "middle_name": "BOISVERT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-06",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLE",
            "last_name": "JONES",
            "middle_name": "BOISVERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.