Active NPI
Mystie Ann Harmon, OTA
- Occupational Therapy Assistant
- Shreveport, LA
National Provider Identifier
1750655775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- Z20632
- Practice address
- 1536 Claiborne Ave
Shreveport, LA 71103-4206 - Phone
- (903) 407-9114
- NPI assigned
- Mar 8, 2012
- Last updated
- Mar 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | Z20632 | LA | Primary |
Addresses
Primary practice location
1536 Claiborne Ave
Shreveport, LA 71103-4206
Mailing address
1536 Claiborne Ave
Shreveport, LA 71103-4206
Phone (903) 407-9114
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
| License | State | Type | Specialty |
|---|---|---|---|
| Z20632 | LA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331164800000",
"number": "1750655775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1536 CLAIBORNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034206",
"telephone_number": "903-407-9114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1536 CLAIBORNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034206",
"telephone_number": "903-407-9114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARMON",
"first_name": "MYSTIE",
"middle_name": "ANN",
"credential": "OTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-08",
"last_updated": "2012-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "LA",
"license": "Z20632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.