Active NPI
Corrie Brackin, OTR
- Occupational Therapist
- Beaumont, TX
National Provider Identifier
1740694124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 109549
- Practice address
- 87 Interstate 10 N
Suite 225
Beaumont, TX 77707-2544 - Phone
- (409) 835-0228
- NPI assigned
- Jun 13, 2014
- 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 Therapist | 225X00000X | 109549 | TX | Primary |
Addresses
Primary practice location
87 Interstate 10 N
Suite 225
Beaumont, TX 77707-2544
Mailing address
87 Interstate 10 N
Suite 225
Beaumont, TX 77707-2544
Phone (409) 835-0228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230605002008 | TX | Practitioner - Occupational Therapist in Private Practice | 4183081250 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Texas Pediatric Therapy, PLLC | Occupational Therapist | Current | 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.
-
- Physical Therapist
- Vidor, TX
- NPI 1952911729
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402617600000",
"number": "1740694124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 INTERSTATE 10 N",
"address_2": "SUITE 225",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777072544",
"telephone_number": "409-835-0228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 INTERSTATE 10 N",
"address_2": "SUITE 225",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777072544",
"telephone_number": "409-835-0228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACKIN",
"first_name": "CORRIE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-13",
"last_updated": "2014-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "109549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.