NPIMap

Organization Active NPI

Nic-Drew, Inc.

Doing business as Lake Travis Health

  • Occupational Therapist
  • Lakeway, TX
National Provider Identifier
1750882205
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
NIC-DREW, INC.
Doing business as
Lake Travis Health
Practice address
105 Eagle CV
Lakeway, TX 78734-5010
Phone
(512) 520-6598
Fax
(855) 779-1943
NPI assigned
Feb 21, 2018
Last updated
Feb 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Authorized official

Name
Katharine Grevera, OTNPI 1114375441
Title
Owner, Director
Phone
(512) 520-6598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

105 Eagle CV
Lakeway, TX 78734-5010

Mailing address

105 Eagle CV
Lakeway, TX 78734-5010
Phone (512) 520-6598

Other identifiers 1

IdentifierTypeStateIssuer
106088OtherTXTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Other names 1

  • LAKE TRAVIS HEALTH Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1750882205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 EAGLE CV",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345010",
            "telephone_number": "512-520-6598",
            "fax_number": "855-779-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EAGLE CV",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787345010",
            "telephone_number": "512-520-6598",
            "fax_number": "855-779-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIC-DREW, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "GREVERA",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_title_or_position": "OWNER, DIRECTOR",
        "authorized_official_telephone_number": "512-520-6598",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS",
            "identifier": "106088",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE TRAVIS HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeway, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.