Individual provider Active NPI

Chelsea Nine

  • Occupational Therapist
  • Texarkana, TX
National Provider Identifier
1780025403
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
119526 Issued in TX
Practice address
6101 N State Line Ave
Texarkana, TX 75503-5309
Phone
(903) 791-2270
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 119526 TX Primary

Addresses

Primary practice location

6101 N State Line Ave
Texarkana, TX 75503-5309

Mailing address

1362 B K Pickering Dr
Texarkana, TX 75501-0906
Phone (903) 733-5275

Other practice location 1

17706 I-30
Ste. 3
Benton, AR 72019-2907
Phone (501) 315-4414

Other identifiers 1

IdentifierTypeStateIssuer
199523721MedicaidAR

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
119526TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Special Education Center, Inc. PastSince Aug 14, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1780025403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1362 B K PICKERING DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755010906",
            "telephone_number": "903-733-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 N STATE LINE AVE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035309",
            "telephone_number": "903-791-2270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17706 I-30",
            "address_2": "Ste. 3",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "AR",
            "postal_code": "720192907",
            "country_code": "US",
            "telephone_number": "501-315-4414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NINE",
        "first_name": "CHELSEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "119526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199523721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.