Individual provider Active NPI

Josefina Charles, OTR

  • Occupational Therapist
  • Laredo, TX
National Provider Identifier
1790094910
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
111796 Issued in TX
Practice address
1701 Tournament Trail Dr
Laredo, TX 78041
Phone
(956) 727-3422
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 111796 TX
Occupational Therapist 225X00000X 111796 TX Primary

Addresses

Primary practice location

1701 Tournament Trail Dr
Laredo, TX 78041

Mailing address

10732 Patron Loop
Laredo, TX 78045-6526

Other practice location 1

1405 Jacaman Rd Ste 102
Laredo, TX 78041-6225
Phone (956) 602-1390

Other practice location 2

1405 Jacaman Rd Ste 106
Laredo, TX 78041-6225
Phone (956) 608-3050

Other identifiers 1

IdentifierTypeStateIssuer
1714362-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312002081 TX Practitioner - Occupational Therapist in Private Practice 1850737974 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111796TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Place, LLC Occupational Therapist CurrentSince Sep 28, 2025 Accepting new patients
South Texas Direct Kids LLC Occupational Therapist CurrentSince Feb 16, 2024 Accepting new patients

Locations

1405 Jacaman Rd
Ste 106
Laredo, TX 78041
Phone (956) 568-0003

1405 Jacaman Rd
Ste 102
Laredo, TX 78041
Phone (956) 602-1390

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1790094910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10732 PATRON LOOP",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 TOURNAMENT TRAIL DR",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-727-3422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Jacaman Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Laredo",
            "state": "TX",
            "postal_code": "780416225",
            "country_code": "US",
            "telephone_number": "956-602-1390",
            "fax_number": "956-602-1392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 Jacaman Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Laredo",
            "state": "TX",
            "postal_code": "780416225",
            "country_code": "US",
            "telephone_number": "956-608-3050",
            "fax_number": "956-608-3097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "JOSEFINA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "TX",
            "license": "111796",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "111796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1714362-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.