Individual provider Active NPI

Mary Sue Farrier, OTR

  • Pediatric Occupational Therapist
  • Keller, TX
National Provider Identifier
1972737419
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
109942 Issued in TX
Practice address
1652 Keller Parkway
Ste 100
Keller, TX 76248-3876
Phone
(817) 562-3111
Fax
(817) 562-3114
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 109942 TX Primary

Addresses

Primary practice location

1652 Keller Parkway
Ste 100
Keller, TX 76248-3876

Mailing address

1652 Keller Parkway
Ste 100
Keller, TX 76248-3876
Phone (817) 562-3111

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
109942TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapedia, LLC CurrentSince Sep 23, 2021 Accepting new patients

Locations

17516 Matany Rd
Ste 100
Justin, TX 76247
Phone (714) 904-2003

1652 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (817) 562-3111

1101 Keller Pkwy
Keller, TX 76248
Phone (817) 562-3111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1972737419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 KELLER PARKWAY",
            "address_2": "STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483876",
            "telephone_number": "817-562-3111",
            "fax_number": "817-562-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 KELLER PARKWAY",
            "address_2": "STE 100",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483876",
            "telephone_number": "817-562-3111",
            "fax_number": "817-562-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIER",
        "first_name": "MARY SUE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "109942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.