Active NPI
Colin W Cantwell
- Occupational Therapy Assistant
- Irving, TX
National Provider Identifier
1609646124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 212717
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 212717 | TX | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FST, LLC | Current | 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.
-
- Home Health Agency
- Irving, TX
- NPI 1952602476
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.