Courtney Lynn Shaw, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.014733 Issued in IL

Practice address

534 W 5TH Ave
Naperville, IL 60563-2901

Phone

(630) 300-0640

NPI assigned

Feb 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• The Balanced Kid, Inc.

  • Pediatric Occupational Therapist
  • Westmont, IL
  • NPI 1336636257
  NPD (past)

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1023763596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7N275 WINDSOR DR",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601756327",
            "telephone_number": "630-488-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 W 5TH AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632901",
            "telephone_number": "630-300-0640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 N Cass Ave Ste 311",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605596403",
            "country_code": "US",
            "telephone_number": "630-300-0640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.014733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Lynn Sharon, MSW, LSW
• Sharshon Pharmacy Inc
• Bimal H Shastri
• Rucha B Shastri, MA, LCPC
• Alyssa Shaw, LPC
• Emmanuel Shaw
• Judith Shaw
• Lashara Shaw, LCPC
• Leon Shaw
• Sarah Shaw

• Occupational Therapist in Naperville, IL
• Providers in Naperville, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.