Stuart Brad Clontz

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

107885 Issued in TX

Practice address

5316 Trail Lake Dr
Fort Worth, TX 76133-1931

Phone

(817) 292-8787

Fax

(817) 789-6849

NPI assigned

Mar 19, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1144954074

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Williamsburg, VA
  • NPI 1881366730

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1770858110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5316 TRAIL LAKE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761331931",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 TRAIL LAKE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761331931",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONTZ",
        "first_name": "STUART",
        "middle_name": "BRAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "107885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinical Neuroscience PA
• Clinicare Home Health Services
• Clinicas Sin Fronteras Fort Worth Inc
• Andryce Clinkscales
• Shalin Clonch
• Cherish Clouse
• Noelle Gillette Cloven, M.D.
• Lyndsay Nicole Clowdus, NNP
• Juliet Clutter, PA-C
• Cmac Counseling, PLLC

• Occupational Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.