Active NPI
Tracy Carroll Renfrow, OTR/L
- Occupational Therapist
- Irving, TX
National Provider Identifier
1922353218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT12609
- Practice address
- 5001 Statesman Dr
Irving, TX 75063-2414 - Phone
- (800) 788-4815
- NPI assigned
- Jul 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT12609 | FL | Primary |
Addresses
Primary practice location
5001 Statesman Dr
Irving, TX 75063-2414
Mailing address
13615 Biscayne Grove LN
Grand Island, FL 32735-9647
Phone (352) 205-9775
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT12609 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343001600000",
"number": "1922353218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13615 BISCAYNE GROVE LN",
"city": "GRAND ISLAND",
"state": "FL",
"postal_code": "327359647",
"telephone_number": "352-205-9775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 STATESMAN DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750632414",
"telephone_number": "800-788-4815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENFROW",
"first_name": "TRACY",
"middle_name": "CARROLL",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-23",
"last_updated": "2012-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT12609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
- Remedy Addictions Counselors, Rac, Inc.
- Remington Pharmacy Inc.
- Remington Resources Incorporated
- Renewed Chiropractic and Wellness Center, PLLC
- Shemeka Denise Renfro, OTA
- Hemalatha Rengarajan, M.S. CCC SLP
- Eric Rennekamp
- Jesuschristopher Rodriguez Renteria, CNIM
- Rosemarie Resendez, D.P.M.
- Carla Resendiz, HIS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.