NPIMap

Individual provider Active NPI

Kristi Shoaf, OT

  • Occupational Therapist
  • Las Cruces, NM
National Provider Identifier
1043374424
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1503 Issued in NM
Practice address
301 Perkins Dr
Ste C
Las Cruces, NM 88005-3248
Phone
(575) 523-7243
Fax
(575) 525-5641
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1503 NM Primary

Addresses

Primary practice location

301 Perkins Dr
Ste C
Las Cruces, NM 88005-3248

Mailing address

301 Perkins Dr
Ste C
Las Cruces, NM 88005-3248
Phone (575) 523-7243

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1503NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Therapy Services, LLP Past Accepting new patients
Gallien Inc PastSince Apr 8, 2004 Accepting new patients
Back in Action Therapy LLC PastSince Jun 6, 2013 Accepting new patients

Organizations & group practices 3

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1043374424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PERKINS DR",
            "address_2": "STE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053248",
            "telephone_number": "575-523-7243",
            "fax_number": "575-525-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PERKINS DR",
            "address_2": "STE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053248",
            "telephone_number": "575-523-7243",
            "fax_number": "575-525-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOAF",
        "first_name": "KRISTI",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "1503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.