Active NPI
Melinda Shane Cantrell, OT
- Occupational Therapist
- Big Rock, VA
National Provider Identifier
1841532645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119003456
- Practice address
- 1069 School House Road
Big Rock, VA 24603 - Phone
- (276) 530-7260
- NPI assigned
- Mar 20, 2013
- Last updated
- Mar 20, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0119003456 | VA | Primary |
Addresses
Primary practice location
1069 School House Road
Big Rock, VA 24603
Mailing address
1069 Schoolhouse Road
Big Rock, VA 24603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184774598 | Medicaid | VA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119003456 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363737600000",
"number": "1841532645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1069 SCHOOLHOUSE ROAD",
"city": "BIG ROCK",
"state": "VA",
"postal_code": "24603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1069 SCHOOL HOUSE ROAD",
"city": "BIG ROCK",
"state": "VA",
"postal_code": "24603",
"telephone_number": "276-530-7260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTRELL",
"first_name": "MELINDA",
"middle_name": "SHANE",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-20",
"last_updated": "2013-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119003456",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184774598",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.