Active NPI
Tanee Brooke Colburn, OT
- Occupational Therapist
- Moulton, TX
National Provider Identifier
1780855627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 112292
- Practice address
- 101 South Lancaster Street
Moulton, TX 77975 - Phone
- (361) 596-7373
- NPI assigned
- Mar 19, 2008
- Last updated
- Aug 17, 2018
- 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 | 112292 | TX | Primary |
Addresses
Primary practice location
101 South Lancaster Street
Moulton, TX 77975
Mailing address
3841 County Road 265
Moulton, TX 77975-4878
Phone (361) 772-4921
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 |
|---|---|---|---|
| 112292 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534464000000",
"number": "1780855627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3841 COUNTY ROAD 265",
"city": "MOULTON",
"state": "TX",
"postal_code": "779754878",
"telephone_number": "361-772-4921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SOUTH LANCASTER STREET",
"city": "MOULTON",
"state": "TX",
"postal_code": "77975",
"telephone_number": "361-596-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBURN",
"first_name": "TANEE",
"middle_name": "BROOKE",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2018-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "112292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moulton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.