Individual provider Active NPI

Cletis Mathew Lawson, OT

  • Occupational Therapist
  • McMinnville, TN
National Provider Identifier
1164099743
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5059 Issued in TN
Practice address
1559 Sparta St
McMinnville, TN 37110-1316
Phone
(931) 815-4367
Fax
(931) 815-4630
NPI assigned
Jun 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 5059 TN Primary

Addresses

Primary practice location

1559 Sparta St
McMinnville, TN 37110-1316

Mailing address

PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624003144 TN Practitioner - Occupational Therapist in Private Practice 1850792029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLC 390 clinicians

Practice addresses (Care Compare)

1559 Sparta St
McMinnville, TN 37110-1316
Phone (931) 815-4367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5059TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Occupational Therapist CurrentSince Jun 21, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1164099743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 SPARTA ST",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371101316",
            "telephone_number": "931-815-4367",
            "fax_number": "931-815-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "CLETIS",
        "middle_name": "MATHEW",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "5059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.

Verify at the official NPI Registry.