Individual provider Active NPI

Justin D Hall, COTA

  • Occupational Therapy Assistant
  • Weslaco, TX
National Provider Identifier
1710532411
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
212850 Issued in TX
Practice address
1525 E 6TH St Ste B
Weslaco, TX 78596-4667
Phone
(956) 969-9400
Fax
(956) 969-9411
NPI assigned
Aug 8, 2019
Last updated
Aug 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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 212850 TX Primary

Addresses

Primary practice location

1525 E 6TH St Ste B
Weslaco, TX 78596-4667

Mailing address

1738 N 77 Sunshinestrip
Harlingen, TX 78550-4255
Phone (956) 744-0096

Other identifiers 1

IdentifierTypeStateIssuer
262858905MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL therapyrus@hotmail.com

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
212850TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1710532411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 N 77 SUNSHINESTRIP",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785504255",
            "telephone_number": "956-744-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 6TH ST STE B",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785964667",
            "telephone_number": "956-969-9400",
            "fax_number": "956-969-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262858905",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "therapyrus@hotmail.com",
            "affiliation": "N",
            "address_1": "1525 E 6th St Ste B",
            "city": "Weslaco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785964667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

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