Individual provider Active NPI

Anastasia Andris Cantrell

  • Physical Therapist
  • Warner Robins, GA
National Provider Identifier
1942221767
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002371 Issued in GA
Practice address
405 Osigian Blvd
The Cantrell Center for Physical Therapy & Sports Med
Warner Robins, GA 31088
Phone
(478) 953-3535
Fax
(478) 953-0353
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT002371 GA Primary

Addresses

Primary practice location

405 Osigian Blvd
The Cantrell Center for Physical Therapy & Sports Med
Warner Robins, GA 31088

Mailing address

405 Osigian Blvd
The Cantrell Center for Physical Therapy & Sports Med
Warner Robins, GA 31088
Phone (478) 953-3535

Other identifiers 1

IdentifierTypeStateIssuer
5Z060799OtherGABCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081029000666 GA Practitioner - Physical Therapist in Private Practice 7113983990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

405 Osigian Blvd
Warner Robins, GA 31088-8958
Phone (478) 953-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2371GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cantrell Center for Physical Therapy and Sports Medicine, P.C. CurrentSince Jun 29, 1992 Accepting new patients

Locations

281 Carl Vinson Pkwy
Ste I
Warner Robins, GA 31088
Phone (478) 329-9948

405 Osigian Blvd
Warner Robins, GA 31088
Phone (478) 953-3535

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942221767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OSIGIAN BLVD",
            "address_2": "THE CANTRELL CENTER FOR PHYSICAL THERAPY & SPORTS MED",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-953-3535",
            "fax_number": "478-953-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OSIGIAN BLVD",
            "address_2": "THE CANTRELL CENTER FOR PHYSICAL THERAPY & SPORTS MED",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-953-3535",
            "fax_number": "478-953-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "ANASTASIA",
        "middle_name": "ANDRIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT002371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5Z060799",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.