Individual provider Active NPI

Bethany Dawn Warner, MS, OTRL

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1861682809
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
120550 Issued in TX
Practice address
4201 Bridgeview Dr
Fort Worth, TX 76109-9571
Phone
(817) 476-2480
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 014302-1 NY
Occupational Therapist 225X00000X 120550 TX Primary

Addresses

Primary practice location

4201 Bridgeview Dr
Fort Worth, TX 76109-9571

Mailing address

4201 Bridgeview Dr
Fort Worth, TX 76109-9571
Phone (817) 476-2480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201028001585 TX Practitioner - Occupational Therapist in Private Practice 8628488996 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
014302-1NYMDOccupational Therapist
120550TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists Outpatient, LLC Occupational Therapist CurrentSince Jun 6, 2024 Accepting new patients
Rehab Specialists Outpatient, LLC Occupational Therapist CurrentSince Jun 6, 2024 Accepting new patients

Locations

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

1600 Texas St
Ofc
Fort Worth, TX 76102
Phone (817) 338-3406

1600 Texas St
Ft Worth, TX 76102
Phone (817) 338-2400

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1861682809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 BRIDGEVIEW DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761099571",
            "telephone_number": "817-476-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 BRIDGEVIEW DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761099571",
            "telephone_number": "817-476-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "BETHANY",
        "middle_name": "DAWN",
        "credential": "MS, OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014302-1",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 13, 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.