Individual provider Active NPI

Corie Engleka

  • Occupational Therapy Assistant
  • Corpus Christi, TX
National Provider Identifier
1750623922
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
209969 Issued in TX
Practice address
4444 Corona Dr
Suite 234
Corpus Christi, TX 78411-4324
Phone
(361) 854-1110
Fax
(817) 789-6849
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 209969 TX Primary
Occupational Therapy Assistant 224Z00000X A02210 MD

Addresses

Primary practice location

4444 Corona Dr
Suite 234
Corpus Christi, TX 78411-4324

Mailing address

2905 Santa Fe St
Apt 1
Corpus Christi, TX 78404-1672
Phone (361) 232-9045

Other identifiers 2

IdentifierTypeStateIssuer
149984001MedicaidTX
207164901MedicaidTX

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
A02210MDMDOccupational Therapy Assistant
209969TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1750623922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 SANTA FE ST",
            "address_2": "APT 1",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784041672",
            "telephone_number": "361-232-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 CORONA DR",
            "address_2": "SUITE 234",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114324",
            "telephone_number": "361-854-1110",
            "fax_number": "817-789-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLEKA",
        "first_name": "CORIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "209969",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A02210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.