Active NPI
Sheryl Kay Bourque, COTA
- Occupational Therapist
- Kingwood, TX
National Provider Identifier
1770914566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 210076
- Practice address
- 20000 Kingwood Dr
Kingwood, TX 77339-3801 - Phone
- (281) 610-1615
- NPI assigned
- Dec 5, 2013
- 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 | 210076 | TX | Primary |
Addresses
Primary practice location
20000 Kingwood Dr
Kingwood, TX 77339-3801
Mailing address
20000 Kingwood Dr
Kingwood, TX 77339-3801
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 |
|---|---|---|---|
| 210076 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1770914566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20000 KINGWOOD DR",
"city": "KINGWOOD",
"state": "TX",
"postal_code": "773393801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20000 KINGWOOD DR",
"city": "KINGWOOD",
"state": "TX",
"postal_code": "773393801",
"telephone_number": "281-610-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURQUE",
"first_name": "SHERYL",
"middle_name": "KAY",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-05",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "210076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingwood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.