Individual provider Active NPI

Quenton McCallister

  • Occupational Therapist
  • Scottsdale, AZ
National Provider Identifier
1255777173
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6034 Issued in AZ
Practice address
1475 N Granite Reef Rd
Scottsdale, AZ 85257
Phone
(480) 990-1904
NPI assigned
May 18, 2013
Last updated
May 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6034 AZ Primary
Occupational Therapy Assistant 224Z00000X 4877 AZ

Addresses

Primary practice location

1475 N Granite Reef Rd
Scottsdale, AZ 85257

Mailing address

2902 W Sweetwater Ave Apt 3190
Phoenix, AZ 85029-6309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180208001534 AZ Practitioner - Occupational Therapist in Private Practice 6002175502 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4877AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Achievement Therapy Services CurrentSince Dec 1, 2020 Accepting new patients
Theraplay4Kidz, LLC Occupational Therapist CurrentSince Jun 1, 2020 Accepting new patients
Theracare PLLC Occupational Therapist CurrentSince Jun 1, 2020 Accepting new patients
Heartland Therapy, Inc. Past Accepting new patients

Locations

2830 E Brown Rd
Ste 1
Mesa, AZ 85213
Phone (480) 830-1188

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

Organizations & group practices 4

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": "1368835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1255777173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 W SWEETWATER AVE APT 3190",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850296309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 N GRANITE REEF RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85257",
            "telephone_number": "480-990-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLISTER",
        "first_name": "QUENTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-18",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "6034",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "4877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.