Individual provider Active NPI

Gnanasundri Yanam Govender, OTD, OTR/L, S/C

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1912396367
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
112890 Issued in TX
Practice address
2203 Babcock Rd
San Antonio, TX 78229-4412
Phone
(210) 614-3911
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3217 NM
Occupational Therapist 225X00000X 4348 FL
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 112890 TX Primary

Addresses

Primary practice location

2203 Babcock Rd
San Antonio, TX 78229-4412

Mailing address

2203 Babcock Rd
San Antonio, TX 78229-4412
Phone (210) 614-3911

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
3217NMMDSpecialist
4348FLMDOccupational Therapist
112890TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1912396367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 BABCOCK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294412",
            "telephone_number": "210-614-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 BABCOCK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294412",
            "telephone_number": "210-614-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVENDER",
        "first_name": "GNANASUNDRI YANAM",
        "credential": "OTD, OTR/L, S/C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "3217",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "4348",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112890",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 12, 2023; 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.