Individual provider Active NPI

Melissa Colcord, MSOT, OTR/L

  • Occupational Therapist
  • Sylvania, OH
National Provider Identifier
1780066753
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.007706 Issued in OH
Practice address
4121 King Rd
Sylvania, OH 43560-4438
Phone
(419) 517-8200
Fax
(419) 517-8209
NPI assigned
Jun 25, 2015
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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 OT.007706 OH Primary

Addresses

Primary practice location

4121 King Rd
Sylvania, OH 43560-4438

Mailing address

4121 King Rd
Sylvania, OH 43560-4438
Phone (419) 517-8200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111000560 OH Practitioner - Occupational Therapist in Private Practice 2163956319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT.007706OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Oct 1, 2024 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Oct 1, 2024 Accepting new patients

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1780066753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 KING RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435604438",
            "telephone_number": "419-517-8200",
            "fax_number": "419-517-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 KING RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435604438",
            "telephone_number": "419-517-8200",
            "fax_number": "419-517-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLCORD",
        "first_name": "MELISSA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT.007706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.