Individual provider Active NPI

Marissa Perry, COTA/L

  • Occupational Therapy Assistant
  • Plano, TX
National Provider Identifier
1942750997
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
215593 Issued in TX
Practice address
680 Executive Dr Apt 5311
Plano, TX 75074-0263
Phone
(972) 977-5888
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X TA3155 MS
Occupational Therapy Assistant 224Z00000X 215593 TX Primary

Addresses

Primary practice location

680 Executive Dr Apt 5311
Plano, TX 75074-0263

Mailing address

74 3Rd St
Cleveland, MS 38732-9745
Phone (662) 721-0272

Other practice location 1

74 3rd St
Cleveland, MS 38732-9745
Phone (662) 721-0272

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
TA3155MSMDOccupational Therapy Assistant
215593TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1942750997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 3RD ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387329745",
            "telephone_number": "662-721-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 EXECUTIVE DR APT 5311",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740263",
            "telephone_number": "972-977-5888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 3rd St",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "MS",
            "postal_code": "387329745",
            "country_code": "US",
            "telephone_number": "662-721-0272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MARISSA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "TA3155",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "215593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.