Haley Fain Cantrell, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT007277 Issued in GA

Practice address

5310 Matt Hwy Ste 105
Cumming, GA 30028-8611

Phone

(470) 239-4255

Fax

(470) 427-2997

NPI assigned

Feb 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1932665783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 MATT HWY STE 105",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300288611",
            "telephone_number": "470-239-4255",
            "fax_number": "470-427-2997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Jennings Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777238",
            "country_code": "US",
            "telephone_number": "706-552-1920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "HALEY",
        "middle_name": "FAIN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT007277",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT007277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003215873C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaneile Anmarie Campbell
• Joshua C Canavan, PHARM D
• Kaylena Blaise Cancro
• Canton Road Urgent Care LLC
• Amber Jean Cantrell, MS, OTR/L
• Mallori Cantrell, PT,DPT
• Patricia Joan Caprara, LPC
• Cardinal Counseling LLC
• Care About You LLC
• Care Place Inc

• Pediatric Occupational Therapist in Cumming, GA
• Providers in Cumming, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.