Individual provider Active NPI

Larry Gene Crockett, COTA

  • Occupational Therapy Assistant
  • Abilene, TX
National Provider Identifier
1881711091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
202625 Issued in TX
Practice address
2617 Antilley Rd
Abilene, TX 79606-5109
Phone
(325) 437-1184
Fax
(325) 437-3314
NPI assigned
Mar 23, 2007
Sex
Male
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 Therapy Assistant 224Z00000X 202625 TX Primary

Addresses

Primary practice location

2617 Antilley Rd
Abilene, TX 79606-5109

Mailing address

2345 FM 1750
Abilene, TX 79602-5509
Phone (235) 437-1184

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
202625TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881711091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 FM 1750",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796025509",
            "telephone_number": "235-437-1184",
            "fax_number": "325-437-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 ANTILLEY RD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065109",
            "telephone_number": "325-437-1184",
            "fax_number": "325-437-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "LARRY",
        "middle_name": "GENE",
        "name_prefix": "Mr.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "202625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, 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.