Active NPI
Cassie Fullingim Patzig, OTR
- Multi-Specialty Clinic/Center
- Lubbock, TX
National Provider Identifier
1699945253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- License
- 112546
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 112546 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Chiropractor
- Lubbock, TX
- NPI 1992147375
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.