Individual provider Active NPI

Zachary Scott, OTR/L, CLT

  • Occupational Therapist
  • Cleveland, TN
National Provider Identifier
1033781364
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5347 Issued in TN
Practice address
2255 Candies LN NW
Cleveland, TN 37312-2661
Phone
(423) 472-4700
NPI assigned
Jul 15, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5347 TN Primary

Addresses

Primary practice location

2255 Candies LN NW
Cleveland, TN 37312-2661

Mailing address

114 Hunter LN
Ringgold, GA 30736-3278
Phone (423) 903-1214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823002866 TN Practitioner - Occupational Therapist in Private Practice 7719382183 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5347TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 19, 2021 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 19, 2021 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

2255 Candies Ln NW
Cleveland, TN 37312
Phone (423) 458-1708

Organizations & group practices 2

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": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1033781364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HUNTER LN",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307363278",
            "telephone_number": "423-903-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CANDIES LN NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122661",
            "telephone_number": "423-472-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ZACHARY",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "5347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.