Active NPI
Abimbola Guobadia
- Occupational Therapist
- Fort Worth, TX
National Provider Identifier
1770993016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 115991
- Practice address
- 3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277 - Phone
- (817) 569-4300
- NPI assigned
- May 7, 2014
- Last updated
- Jun 9, 2015
- 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 | 115991 | TX | Primary |
Addresses
Primary practice location
3840 Hulen St
HTN, Client Accounting
Fort Worth, TX 76107-7277
Mailing address
PO Box 2603
HTN, Client Accounting
Fort Worth, TX 76113-2603
Phone (817) 569-4300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 332016001 | Medicaid | TX | |
| 83TT94 | Other | TX | BCBS |
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 |
|---|---|---|---|
| 115991 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1770993016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2603",
"address_2": "HTN, CLIENT ACCOUNTING",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761132603",
"telephone_number": "817-569-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3840 HULEN ST",
"address_2": "HTN, CLIENT ACCOUNTING",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761077277",
"telephone_number": "817-569-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUOBADIA",
"first_name": "ABIMBOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "115991",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "332016001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "83TT94",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.