NPIMap

Individual provider Active NPI

Amber Lynn Boswell, C.O.T.A

  • Occupational Therapy Assistant
  • Tyler, TX
National Provider Identifier
1952788754
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
213039 Issued in TX
Practice address
1001 WSW Loop 323
Tyler, TX 75701-9416
Phone
(903) 509-1313
Fax
(903) 509-1383
NPI assigned
Apr 30, 2015
Last updated
Apr 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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 213039 TX Primary

Addresses

Primary practice location

1001 WSW Loop 323
Tyler, TX 75701-9416

Mailing address

1001 WSW Loop 323
Tyler, TX 75701-9416
Phone (903) 509-1313

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
213039TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Pediatric Rehabilitation Associates Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1952788754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WSW LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019416",
            "telephone_number": "903-509-1313",
            "fax_number": "903-509-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WSW LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019416",
            "telephone_number": "903-509-1313",
            "fax_number": "903-509-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "credential": "C.O.T.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "213039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.