Matthew Cecilio, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA0000002508 Issued in TN

Practice address

298 Warfield Blvd
Suite C
Clarksville, TN 37043-1828

Phone

(931) 906-0440

Fax

(931) 920-5070

NPI assigned

Aug 6, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1770969289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 LOUISE RD",
            "city": "CUMBERLAND FURNACE",
            "state": "TN",
            "postal_code": "370519088",
            "telephone_number": "703-851-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WARFIELD BLVD",
            "address_2": "SUITE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431828",
            "telephone_number": "931-906-0440",
            "fax_number": "931-920-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECILIO",
        "first_name": "MATTHEW",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "OTA0000002508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Occupational Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.