Individual provider Active NPI

Laurie Lynne Tate, OTR

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1811061583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
111940 Issued in TX
Practice address
85 NE Loop 410
Suite 209
San Antonio, TX 78216-5829
Phone
(210) 340-2627
Fax
(210) 340-6437
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 111940 TX Primary

Addresses

Primary practice location

85 NE Loop 410
Suite 209
San Antonio, TX 78216-5829

Mailing address

5623 Hamilton Wolfe
Apt 321
San Antonio, TX 78240-3991
Phone (210) 340-2627

Other identifiers 1

IdentifierTypeStateIssuer
8T6604OtherTXBLUE CROSS BLUE SHEILD ID

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
111940TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Treehouse Behavioral Services Past Accepting new patients
Treehouse Pediatric Center Occupational Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811061583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 HAMILTON WOLFE",
            "address_2": "APT 321",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403991",
            "telephone_number": "210-340-2627",
            "fax_number": "210-340-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 NE LOOP 410",
            "address_2": "SUITE 209",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782165829",
            "telephone_number": "210-340-2627",
            "fax_number": "210-340-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "LAURIE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "111940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD ID",
            "identifier": "8T6604",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.