Individual provider Active NPI

Alicia Spencer, COTA

  • Occupational Therapy Assistant
  • Lake Dallas, TX
National Provider Identifier
1942528880
Registry record updated May 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
209284 Issued in TX
Practice address
510 Liberty Way
Lake Dallas, TX 75065-3490
Phone
(940) 595-0109
NPI assigned
May 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2010

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 209284 TX Primary

Addresses

Primary practice location

510 Liberty Way
Lake Dallas, TX 75065-3490

Mailing address

510 Liberty Way
Lake Dallas, TX 75065-3490

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
209284TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1273968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273968000000",
    "number": "1942528880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LIBERTY WAY",
            "city": "LAKE DALLAS",
            "state": "TX",
            "postal_code": "750653490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 LIBERTY WAY",
            "city": "LAKE DALLAS",
            "state": "TX",
            "postal_code": "750653490",
            "telephone_number": "940-595-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "ALICIA",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-16",
        "last_updated": "2010-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "209284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2010; 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.