KELLI WAGGONNER (NPI# 1790320034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790320034 |
| Entity Type | Individual |
| Full Name | KELLI WAGGONNER |
| Practice Address |
8595 Medical Center Blvd Port Arthur TX 77640-2428 |
| Mailing Address |
5685 Pat Dr Orange TX 77630-7571 |
| Practice Telephone | 4097218600 |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2019-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 212923 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
8595 MEDICAL CENTER BLVD |
| City | PORT ARTHUR |
| State | TX |
| Zip Code | 77640-2428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801375175 | Danae Simmons | Speech-Language Pathologist | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-08 |
| 1780213199 | Maryam Khalily Rahmani | Nurse Practitioner | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2020-04-07 |
| 1639700461 | Tyler County Hospital District | Skilled Nursing Facility | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2020-01-30 |
| 1770063653 | Roy Culver Jr. | Physical Therapy Assistant | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-20 |
| 1023598117 | Della Hokett | Occupational Therapy Assistant | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-17 |
| 1730669821 | Chelsea E Fountain | Occupational Therapist | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-17 |
| 1336629864 | Rebecca Ann Dunlap | Occupational Therapy Assistant | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-15 |
| 1306326830 | Trina Ann Bivens | Occupational Therapist | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-14 |
| 1760961759 | Katherine Lafleur Tatum | Speech-Language Pathologist | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275031676 | Grupo Segovia Sc | Specialist | 101 Calle Primera Sur, Adolfo Lopez Mateos, Cozumel, QUINTANA ROO 77640 | 2018-01-31 |
| 1811495575 | Total Care Medical, Pllc | Clinic/Center | 8035 Memorial Blvd Ste B, Port Arthur, TX 77640 | 2018-01-29 |
| 1750805586 | Bv Continuing Care Center Ltd. Co. | Skilled Nursing Facility | 8595 Medical Center Blvd., Port Arthur, TX 77640 | 2017-08-02 |
| 1053840561 | Centro Medico De Cozumel Sa De Cv | General Acute Care Hospital | Calle 1ra Sur No. 101 Adolfo Lopez Mateo, Cozumel, QUINTANA ROO 77640 | 2017-06-08 |
| 1306391719 | Hector Trevino | Dentist | 2780 Fm 365, Port Arthur, TX 77640 | 2016-08-16 |
| 1316325616 | Gulfside Dental Port Arthur Pllc | Dentist | 2780 Hwy 365, Suite C, Port Arthur, TX 77640 | 2015-05-07 |
| 1962894782 | Chris Hale | Specialist/Technologist, Other | 6361 Katy Av, Port Arthur, TX 77640 | 2015-03-03 |
| 1396157681 | Jack 1 Foundation Inc. | Day Training, Developmentally Disabled Services | 235 Procter St., Port Arthur, TX 77640 | 2014-05-21 |
| 1205275054 | Gulf Coast Health Center, Inc | Clinic/Center | 601 Rev Ransom Howard, Bldg B, Port Arthur, TX 77640 | 2013-06-14 |
| 1285909432 | Costamed | General Acute Care Hospital | Calle Primera Sur No. 101, Cozumel, QR 77640 | 2012-03-20 |
| Find all providers in zip 77640 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487102372 | Lisa Nicole Dabney | Occupational Therapy Assistant | 2555 95th St, Apt 2010, Port Arthur, TX 77640-1552 | 2016-09-20 |
| 1023598117 | Della Hokett | Occupational Therapy Assistant | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-17 |
| 1336629864 | Rebecca Ann Dunlap | Occupational Therapy Assistant | 8595 Medical Center Blvd, Port Arthur, TX 77640-2428 | 2018-08-15 |
| 1972707719 | Joli' Marie Huckaby | Occupational Therapy Assistant | 7200 9th Ave, Port Arthur, TX 77642 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215727 | Madison Brooke Foskey | Occupational Therapy Assistant | 3700 Legacy Dr Apt 22105, Frisco, TX 75034-6650 | 2020-11-07 |
| 1528668464 | Jerjean Casalem-dahl | Occupational Therapy Assistant | 8522 Cookglass Dr, Houston, TX 77072-4808 | 2020-10-29 |
| 1144829706 | Dickson Innemeset Etukudoh | Occupational Therapy Assistant | 21630 Merchants Way Ste 200, Katy, TX 77449-2514 | 2020-10-23 |
| 1861091019 | Erin Quinn | Occupational Therapy Assistant | 7130 Durango Creek Dr, Magnolia, TX 77354-2781 | 2020-10-20 |
| 1154920502 | Allison Hill | Occupational Therapy Assistant | 600 Nottingham Oaks Trl Apt 197, Houston, TX 77079-6233 | 2020-10-17 |
| 1518565951 | Susana Sifford | Occupational Therapy Assistant | 14515 Old Tybee Rd, Houston, TX 77084-7158 | 2020-10-16 |
| 1528666088 | Davie Michelle Kennington | Occupational Therapy Assistant | 1100 Sarah Swamy Ln, Sherman, TX 75090 | 2020-10-15 |
| 1386241735 | Tracy Lynn Price | Occupational Therapy Assistant | 15002 Zenith Glen Ln, Cypress, TX 77429-7644 | 2020-10-07 |
| 1003413782 | Gabriela Coronado Lopez | Occupational Therapy Assistant | 3206 Hummingbird Ln, Humble, TX 77396-4136 | 2020-10-05 |
| 1962009746 | Kayci Dawn Lane | Occupational Therapy Assistant | 290 Country Ridge Rd Unit 37, Lewisville, TX 75067-4503 | 2020-10-05 |
| Find all providers with the same taxonomy | ||||
| City | PORT ARTHUR |
| Zip Code | 77640 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.