Active NPI
Jason Lynn Stark, OTR
- Pediatric Occupational Therapist
- Spring, TX
National Provider Identifier
1932272283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 109631
- Practice address
- 16835 Deer Creek Dr Ste 120
Spring, TX 77379-5803 - Phone
- (281) 379-4373
- Fax
- (713) 655-0762
- NPI assigned
- Nov 16, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 109631 | TX | |
| Neurorehabilitation Occupational Therapist | 225XN1300X | 109631 | TX | |
| Pediatric Occupational Therapist | 225XP0200X | 109631 | TX | Primary |
Addresses
Primary practice location
16835 Deer Creek Dr Ste 120
Spring, TX 77379-5803
Mailing address
1022 Euclid St
Houston, TX 77009-7100
Phone (713) 397-2708
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 |
|---|---|---|---|
| 109631 | TX | MD | Neurorehabilitation Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cole Health, Inc. | Past | Accepting new patients | |
| Cole Speech & Language Center, LP | Past | Accepting new patients | |
| Cole Coastal Therapy LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Rehabilitation Clinic/Center
- Houston, TX
- NPI 1841204898
-
- Rehabilitation Clinic/Center
- Spring, TX
- NPI 1659435808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302825600000",
"number": "1932272283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1022 EUCLID ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770097100",
"telephone_number": "713-397-2708",
"fax_number": "281-655-0762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16835 DEER CREEK DR STE 120",
"city": "SPRING",
"state": "TX",
"postal_code": "773795803",
"telephone_number": "281-379-4373",
"fax_number": "713-655-0762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "JASON",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2011-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "109631",
"primary": false
},
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "TX",
"license": "109631",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "109631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.