Individual provider Active NPI

Jennifer Ruth Williams, OTR

  • Occupational Therapist
  • Longview, TX
National Provider Identifier
1679824221
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
113636 Issued in TX
Practice address
110 E Tyler St
Longview, TX 75601
Phone
(903) 600-6797
Fax
(903) 600-6801
NPI assigned
Sep 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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 113636 TX Primary

Addresses

Primary practice location

110 E Tyler St
Longview, TX 75601

Mailing address

110 E Tyler St
Longview, TX 75601-7224
Phone (903) 600-6797

Other practice location 1

1601 N Collins Blvd
Richardson, TX 75080-3520
Phone (972) 470-5855

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
113636TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mathis Therapy - a Therapy Connection, LLC PastSince May 29, 2022 Accepting new patients
Williams Pediatric Therapy, PLLC Past Accepting new patients

Organizations & group practices 2

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": "1348358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1679824221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E TYLER ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756017224",
            "telephone_number": "903-600-6797",
            "fax_number": "972-470-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E TYLER ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75601",
            "telephone_number": "903-600-6797",
            "fax_number": "903-600-6801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 N Collins Blvd",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750803520",
            "country_code": "US",
            "telephone_number": "972-470-5855",
            "fax_number": "972-470-5875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "RUTH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-23",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "113636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.