Individual provider Active NPI

Makenzie Brooke Hollandsworth, COTA

  • Occupational Therapy Assistant
  • Fort Worth, TX
National Provider Identifier
1891448973
Registry record updated Jan 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216968 Issued in TX
Practice address
4011 Benbrook Hwy
Fort Worth, TX 76116-7800
Phone
(817) 386-5500
NPI assigned
Jan 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2022

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 216968 TX Primary

Addresses

Primary practice location

4011 Benbrook Hwy
Fort Worth, TX 76116-7800

Mailing address

4011 Benbrook Hwy
Fort Worth, TX 76116-7800
Phone (817) 386-5500

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
216968TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1891448973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 BENBROOK HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167800",
            "telephone_number": "817-386-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 BENBROOK HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167800",
            "telephone_number": "817-386-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDSWORTH",
        "first_name": "MAKENZIE",
        "middle_name": "BROOKE",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216968",
            "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 Jan 30, 2022; 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.