Individual provider Active NPI

Caitlyn Elder, MOT, OTR/L

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1861047276
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
119111 Issued in TX
Practice address
2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone
(817) 529-1900
NPI assigned
Aug 4, 2019
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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 119111 TX Primary

Addresses

Primary practice location

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124

Mailing address

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone (817) 529-1900

Other names 1

  • Caitlyn Johnson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002003518 CO Practitioner - Occupational Therapist in Private Practice 6305175811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Certified Hand Therapy Services LLCGroup PAC ID 8426394107, 3 clinicians

Practice addresses (Care Compare)

2299 Pearl St
Suite 200
Boulder, CO 80302-4670
Phone (720) 845-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119111TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Certified Hand Therapy Services LLC CurrentSince Sep 6, 2024 Accepting new patients

Locations

2299 Pearl St
Ste 200
Boulder, CO 80302
Phone (720) 845-0001

2299 Pearl St
Ste 300
Boulder, CO 80302

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, 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": "1564876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1861047276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-735-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "CAITLYN",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-04",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "119111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLYN",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.