Shannon Kristin Reardon

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

016409 Issued in NY

Practice address

5 Dakota Dr
New Hyde Park, NY 11042-1107

Phone

(631) 521-1926

NPI assigned

Oct 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1063054047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 NASSAU RD APT 112",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434359",
            "telephone_number": "631-521-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DAKOTA DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421107",
            "telephone_number": "631-521-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "SHANNON",
        "middle_name": "KRISTIN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "meditech",
            "affiliation": "N",
            "address_1": "5 Dakota Dr",
            "city": "New Hyde Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110421107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Seeme Raza, MD
• Syed Abbas Raza
• Bibi Shelleza Razack, MD
• Neelofar Razack, LPN
• Reaction Rehabilitation and Sports Training P.T., P.C.
• Ana Lissette Recinos Baez
• Danielle Laura Recupero, DDS
• Nicole Suzanne Reda, M.S., SLP-CCC
• Arlene Redner, MD
• Kevin Regan, DO

• Occupational Therapist in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.