Individual provider Active NPI

Luke Weems, OTA

  • Occupational Therapy Assistant
  • Tyler, TX
National Provider Identifier
1750950804
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216872 Issued in TX
Practice address
3414 Golden Rd
Tyler, TX 75701-8336
Phone
(903) 939-7500
NPI assigned
Jun 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 216872 TX Primary

Addresses

Primary practice location

3414 Golden Rd
Tyler, TX 75701-8336

Mailing address

4436 FM 177 E
Troup, TX 75789-8530
Phone (903) 969-8028

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
216872TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1750950804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 FM 177 E",
            "city": "TROUP",
            "state": "TX",
            "postal_code": "757898530",
            "telephone_number": "903-969-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 GOLDEN RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018336",
            "telephone_number": "903-939-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEMS",
        "first_name": "LUKE",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.