Individual provider Active NPI

Abby Nicole Johnson, COTA

  • Occupational Therapy Assistant
  • Hill Country Village, TX
National Provider Identifier
1912589581
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216743 Issued in TX
Practice address
15333 San Pedro Ave
Hill Country Village, TX 78232-3719
Phone
(210) 979-0244
NPI assigned
Apr 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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 216743 TX Primary

Addresses

Primary practice location

15333 San Pedro Ave
Hill Country Village, TX 78232-3719

Mailing address

1506 W French PL
San Antonio, TX 78201-5542
Phone (062) 825-7739

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
216743TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A Balanced Child , PLLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

15333 San Pedro Ave
San Antonio, TX 78232
Phone (210) 979-0244

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1912589581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 W FRENCH PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782015542",
            "telephone_number": "062-825-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15333 SAN PEDRO AVE",
            "city": "HILL COUNTRY VILLAGE",
            "state": "TX",
            "postal_code": "782323719",
            "telephone_number": "210-979-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ABBY",
        "middle_name": "NICOLE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hill Country Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.