Active NPI
Geoffrey Alan Supplee, OT
- Occupational Therapist
- Rowlett, TX
National Provider Identifier
1992363022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 120102
- Practice address
- 3005 Lakeview Pkwy Ste 400
Rowlett, TX 75088-3320 - Phone
- (214) 607-9304
- NPI assigned
- Jun 4, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 120102 | TX | Primary |
Addresses
Primary practice location
3005 Lakeview Pkwy Ste 400
Rowlett, TX 75088-3320
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120102 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563408000000",
"number": "1992363022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3005 LAKEVIEW PKWY STE 400",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750883320",
"telephone_number": "214-607-9304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPPLEE",
"first_name": "GEOFFREY",
"middle_name": "ALAN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-04",
"last_updated": "2019-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "120102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.