NPIMap

Organization Active NPI

Shoulder Elbow & Hand Therapy Specialist PC

  • Hand Occupational Therapist
  • Shenandoah, TX
National Provider Identifier
1720351059
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
110312 Issued in TX
Legal business name
SHOULDER ELBOW & HAND THERAPY SPECIALIST PC
Practice address
8850 Six Pines Dr
Suite 240
Shenandoah, TX 77380-2683
Phone
(281) 298-5811
Fax
(281) 298-5849
NPI assigned
Feb 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James C PuettNPI 1275538100
Title
Owner
Phone
(281) 298-5811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XH1200X 110312 TX Primary

Addresses

Primary practice location

8850 Six Pines Dr
Suite 240
Shenandoah, TX 77380-2683

Mailing address

8850 Six Pines Dr
Suite 240
Shenandoah, TX 77380-2683
Phone (281) 298-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120714000067 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375708563 Receives reassigned benefits from 1 practitioner
Practice locations: Shenandoah, TX
O20120718000644 TX DME Supplier - Independently-Practicing Occupational Therapist 3375708563 Practice locations: Shenandoah, TX

National Provider Directory

National Provider Directory

Locations

8850 Six Pines Dr
Ste 240
Shenandoah, TX 77380
Phone (281) 298-5811

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1720351059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8850 SIX PINES DR",
            "address_2": "SUITE 240",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773802683",
            "telephone_number": "281-298-5811",
            "fax_number": "281-298-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8850 SIX PINES DR",
            "address_2": "SUITE 240",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773802683",
            "telephone_number": "281-298-5811",
            "fax_number": "281-298-5849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOULDER ELBOW & HAND THERAPY SPECIALIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "PUETT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-298-5811"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "TX",
            "license": "110312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.