Individual provider Active NPI

Colin W Cantwell

  • Occupational Therapy Assistant
  • Irving, TX
National Provider Identifier
1609646124
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
212717 Issued in TX
Practice address
1333 Corporate Dr Ste 330
Irving, TX 75038-2583
Phone
(972) 871-1800
NPI assigned
Jan 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 212717 TX Primary

Addresses

Primary practice location

1333 Corporate Dr Ste 330
Irving, TX 75038-2583

Mailing address

203 Rockbrook Dr
Wylie, TX 75098-6140
Phone (682) 224-9431

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
212717TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FST, LLC CurrentSince Jan 7, 2024 Accepting new patients

Locations

1333 Corporate Dr
Ste 330
Irving, TX 75038
Phone (972) 871-1800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1609646124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 ROCKBROOK DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750986140",
            "telephone_number": "682-224-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 CORPORATE DR STE 330",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382583",
            "telephone_number": "972-871-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTWELL",
        "first_name": "COLIN",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "212717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.