Cassidy Shannon Qualls, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

1107 E Matthews Ave Ste 105
Jonesboro, AR 72401-4315

Phone

(870) 333-5210

NPI assigned

Sep 11, 2020

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

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Reaper Physical Therapy IncGroup PAC ID 5395637383, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Reaper Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Searcy, AR
  • NPI 1215973342

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Tracy Jones Physical Therapy Services, P.a.

  • Physical Therapy Clinic/Center
  • Jonesboro, AR
  • NPI 1346473139
  Medicare reassignment NPD

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1609481167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "MONETTE",
            "state": "AR",
            "postal_code": "724470277",
            "telephone_number": "870-919-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E MATTHEWS AVE STE 105",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014315",
            "telephone_number": "870-333-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 E Matthews Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724014331",
            "country_code": "US",
            "telephone_number": "870-933-6393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "CASSIDY",
        "middle_name": "SHANNON",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Michelle Puckett, MHPP
• Angela Pugsley, APRN
• Mary Pulliam
• Mary H Pulliam, MCD, CCC-SLP
• David Lee Pyle, M.D.
• Matthew A. Quick, MD
• Matthew Scott Quillman
• Maricella Quinonez
• R. Edward Cooper Jr MD, PA
• R. Edward Cooper Jr., M.D., P.a.

• Occupational Therapist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.