Individual provider Active NPI

Megan Mullins

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1730773276
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025
Phone
(817) 764-3825
NPI assigned
Feb 25, 2021
Last updated
Feb 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025

Mailing address

4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212000381 TX Practitioner - Occupational Therapist in Private Practice 6608306279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

3033 Acme Brick PLZ
Fort Worth, TX 76109-4227
Phone (817) 484-4447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince Feb 1, 2025 Accepting new patients
Little Red Wagon Pediatric Therapy, LLC CurrentSince Mar 4, 2021 Accepting new patients
CLC Therapy Solutions LLC Past Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

4524 Boat Club Rd
Ste 180
Fort Worth, TX 76135
Phone (817) 764-3825

Organizations & group practices 3

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": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1730773276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4524 BOAT CLUB RD STE 180",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 BOAT CLUB RD STE 180",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357025",
            "telephone_number": "817-764-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.