Lynnette Salas, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

212594 Issued in TX

Practice address

925 Santa Fe Dr Ste 110
Weatherford, TX 76086-5867

Phone

(817) 599-7714

Fax

(254) 965-3618

NPI assigned

Aug 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Countryside Therapy Group Home Health, LLC

  • Home Health Agency
  • Stephenville, TX
  • NPI 1952713869
  NPD (past)
• Countryside Therapy Group, Inc

  • Rehabilitation Clinic/Center
  • Stephenville, TX
  • NPI 1710999289

  Occupational Therapy Assistant

  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1164901450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W LINGLEVILLE RD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012211",
            "telephone_number": "254-965-3611",
            "fax_number": "254-965-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SANTA FE DR STE 110",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865867",
            "telephone_number": "817-599-7714",
            "fax_number": "254-965-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAS",
        "first_name": "LYNNETTE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172242301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Russell
• Jayson Rutherford, PHARMD
• Alexandra Ryan, LACMH
• Catherine Saathoff
• Malinda Sachse
• Juliana Dawn Salibsury, PTA
• Sehar Salman
• Alexa Sanchez
• Justin Roy Pacina Sanchez, DO, MS
• Gregory F Sanders

• Occupational Therapy Assistant in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.