Active NPI
Jan Ellen Pittard, OT
- Occupational Therapist
- Decatur, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 109612
- Practice address
- 605 W Mulberry St
Decatur, TX 76234-1263 - Phone
- (940) 627-5444
- NPI assigned
- Aug 6, 2009
- Sex
- Female
- 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 | 109612 | TX | Primary |
Addresses
Primary practice location
605 W Mulberry St
Decatur, TX 76234-1263
Mailing address
916 W College St
Grapevine, TX 76051-5128
Phone (817) 680-0015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220714000328 | TX | Practitioner - Occupational Therapist in Private Practice | 3779964325 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Empowerme Rehabilitation LLC
Practice addresses (Care Compare)
4205 W Northwest Hwy
Parsons House Preston Hollow
Dallas, TX 75220-7802
Phone (469) 489-1536
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109612 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerme Rehabilitation, LLC | Occupational Therapist | Current | Accepting new patients |
| Empowerme Rehabilitation, LLC | Occupational Therapist | Current | Accepting new patients |
| Aegis Group Practice LLC | Occupational Therapist | Current | Accepting new patients |
| Aegis Group Practice LLC | Occupational Therapist | Current | Accepting new patients |
| Aegis Group Practice LLC | Occupational Therapist | Current | Accepting new patients |
| Adaptive Rehabilitation Clinics, LLC | Occupational Therapist | Past | Accepting new patients |
Locations
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
1860 N Cooper St
Arlington, TX 76011
Phone (469) 575-3312
1501 W Campbell Rd
Garland, TX 75044
Phone (469) 609-9153
800 Whitley Rd
Keller, TX 76248
Phone (817) 357-7181
2760 W Walker St
League City, TX 77573
Phone (281) 967-7973
2022 State Highway 46 W
New Braunfels, TX 78132
Phone (830) 743-9324
Organizations & group practices 20
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249516800000",
"number": "1992936009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 W COLLEGE ST",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760515128",
"telephone_number": "817-680-0015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 W MULBERRY ST",
"city": "DECATUR",
"state": "TX",
"postal_code": "762341263",
"telephone_number": "940-627-5444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTARD",
"first_name": "JAN",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-06",
"last_updated": "2009-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "109612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.