Individual provider Active NPI

Ty Daniel O'Grady, OTD

  • Pediatric Occupational Therapist
  • Carrollton, TX
National Provider Identifier
1790509362
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
124965 Issued in TX
Practice address
1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904
Phone
(972) 237-0100
NPI assigned
Nov 11, 2024
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 124965 TX Primary

Addresses

Primary practice location

1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904

Mailing address

508 S Carroll Blvd Apt 256
Denton, TX 76201-0001
Phone (254) 495-3400

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
124965TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CKC Holdings LLC CurrentSince Nov 17, 2024 Accepting new patients
CKC Holdings LLC CurrentSince Nov 17, 2024 Accepting new patients

Locations

1000 W Crosby Rd
Ste 136
Carrollton, TX 75006
Phone (972) 237-0100

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": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1790509362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S CARROLL BLVD APT 256",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762010001",
            "telephone_number": "254-495-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CROSBY RD STE 136",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066904",
            "telephone_number": "972-237-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GRADY",
        "first_name": "TY",
        "middle_name": "DANIEL",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "124965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.