Active NPI
Stacie Deleon Arevalo, COTA
- Occupational Therapy Assistant
- Joshua, TX
National Provider Identifier
1669993234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 213102
- Practice address
- 310 E 18TH St
Joshua, TX 76058-3117 - Phone
- (817) 202-2500
- NPI assigned
- Jul 4, 2017
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 213102 | TX | Primary |
Addresses
Primary practice location
310 E 18TH St
Joshua, TX 76058-3117
Mailing address
4014 Bay Springs CT
Arlington, TX 76016-4744
Phone (817) 773-4554
Other practice location 1
404 Racquet Club Blvd
Bedford, TX 76022-6408
Phone (682) 738-3056
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
| License | State | Type | Specialty |
|---|---|---|---|
| 213102 | TX | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Small Hands Big Hearts Pediatric Therapy Management 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Fort Worth, TX
- NPI 1992012660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1669993234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4014 BAY SPRINGS CT",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760164744",
"telephone_number": "817-773-4554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 E 18TH ST",
"city": "JOSHUA",
"state": "TX",
"postal_code": "760583117",
"telephone_number": "817-202-2500"
}
],
"practiceLocations": [
{
"address_1": "404 Racquet Club Blvd",
"address_purpose": "LOCATION",
"city": "Bedford",
"state": "TX",
"postal_code": "760226408",
"country_code": "US",
"telephone_number": "682-738-3056",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AREVALO",
"first_name": "STACIE",
"middle_name": "DELEON",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-04",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "213102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joshua, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.