Individual provider Active NPI

Melisa Cantrell, M.O.T.

  • Pediatric Occupational Therapist
  • Greenville, SC
National Provider Identifier
1538360292
Registry record updated Feb 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
4056 Issued in SC
Practice address
343 Prado Way
Greenville, SC 29607-6512
Phone
(864) 270-8647
NPI assigned
May 30, 2007
Last updated
Feb 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4056 SC
Occupational Therapist 225X00000X 007243 OH
Pediatric Occupational Therapist 225XP0200X 4056 SC Primary

Addresses

Primary practice location

343 Prado Way
Greenville, SC 29607-6512

Mailing address

715 Thistlewood Dr
Duncan, SC 29334-8965
Phone (606) 584-7409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007243OHMDOccupational Therapist
4056SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Communications Occupational Therapist CurrentSince Sep 17, 2023 Accepting new patients

Locations

343 Prado Way
Greenville, SC 29607
Phone (864) 270-8647

Organizations & group practices 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582329600000",
    "number": "1538360292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 THISTLEWOOD DR",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348965",
            "telephone_number": "606-584-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 PRADO WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076512",
            "telephone_number": "864-270-8647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "MELISA",
        "credential": "M.O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "4056",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "007243",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "4056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2020; 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.