Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Katelyn Cantrell

Individual provider Occupational Therapist · NPI 1104693092

Katelyn Cantrell is an Occupational Therapist in Private Practice in Charleston, Tennessee. Qualified in 2023, 3 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
3
Licensed in
TN
In the registry since
2023

Practice location Address checks out

136 Newport St NW Apt B
Charleston, TN 37310-6318
Phone: (423) 506-5379
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 7845 (TN)

Record details

NPI number1104693092
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 11, 2023
Last updated in NPPESDecember 11, 2023
Certification dateDecember 11, 2023
Mailing address136 Newport St Nw Apt B, Charleston, TN 37310-6318

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount