Active NPI
Shae Sellers, COTA/L
- Occupational Therapy Assistant
- Edmond, OK
National Provider Identifier
1043809148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1679
- Practice address
- 1505 Renaissance Blvd
Edmond, OK 73013-3018 - Phone
- (405) 850-8497
- Fax
- (405) 300-0643
- NPI assigned
- Jan 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1679 | OK | Primary |
Addresses
Primary practice location
1505 Renaissance Blvd
Edmond, OK 73013-3018
Mailing address
1505 Renaissance Blvd
Edmond, OK 73013-3018
Phone (405) 850-8497
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | WWW.ELITETHERAPYOKC.COM | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1679 | OK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Therapy, LLC | Occupational Therapy Assistant | Past | Accepting new patients |
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.
-
- Speech-Language Pathologist
- Edmond, OK
- NPI 1891218202
Occupational Therapy Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1043809148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 RENAISSANCE BLVD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133018",
"telephone_number": "405-850-8497",
"fax_number": "405-300-0643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 RENAISSANCE BLVD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730133018",
"telephone_number": "405-850-8497",
"fax_number": "405-300-0643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "SHAE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-13",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OK",
"license": "1679",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "WWW.ELITETHERAPYOKC.COM",
"affiliation": "N",
"endpointDescription": "WEBSITE",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1505 Renaissance Blvd",
"city": "Edmond",
"state": "OK",
"country_code": "US",
"postal_code": "730133018",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.