Individual provider Active NPI

Cassie Fullingim Patzig, OTR

  • Multi-Specialty Clinic/Center
  • Lubbock, TX
National Provider Identifier
1699945253
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
112546 Issued in TX
Practice address
6110 Nashville Ave
Lubbock, TX 79413-5216
Phone
(806) 792-0604
Fax
(806) 792-0604
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 112546 TX
Multi-Specialty Clinic/Center 261QM1300X 112546 TX Primary

Addresses

Primary practice location

6110 Nashville Ave
Lubbock, TX 79413-5216

Mailing address

5407 4TH St
Suite F
Lubbock, TX 79416-4348
Phone (806) 791-3399

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
112546TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cruth Enterprises, Inc. Multi-Specialty Past Accepting new patients
Korey Kothmann, D.C., PA Past Accepting new patients

Organizations & group practices 2

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1699945253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 4TH ST",
            "address_2": "SUITE F",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794164348",
            "telephone_number": "806-791-3399",
            "fax_number": "806-791-3934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794135216",
            "telephone_number": "806-792-0604",
            "fax_number": "806-792-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATZIG",
        "first_name": "CASSIE",
        "middle_name": "FULLINGIM",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "112546",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TX",
            "license": "112546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.