Individual provider Active NPI

Shauna Rittenhouse, OTR/L

  • Pediatric Occupational Therapist
  • O Fallon, IL
National Provider Identifier
1043618200
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056009782 Issued in IL
Practice address
634 N Main St
Ste 1
O Fallon, IL 62269-3746
Phone
(618) 690-0068
Fax
(888) 452-2930
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 056009782 IL Primary

Addresses

Primary practice location

634 N Main St
Ste 1
O Fallon, IL 62269-3746

Mailing address

634 N Main St
Ste 1
O Fallon, IL 62269-3746
Phone (618) 690-0068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171115001431 MO Practitioner - Occupational Therapist in Private Practice 5698031292 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056009782ILMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Appletree Therapy Services, LLC. Past Accepting new patients

Organizations & group practices 2

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": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1043618200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 N MAIN ST",
            "address_2": "STE 1",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693746",
            "telephone_number": "618-690-0068",
            "fax_number": "888-452-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 N MAIN ST",
            "address_2": "STE 1",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693746",
            "telephone_number": "618-690-0068",
            "fax_number": "888-452-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITTENHOUSE",
        "first_name": "SHAUNA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056009782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.