Individual provider Active NPI

Cherylynn Page Shiley, M.S., OTR/L

  • Occupational Therapist
  • Lansdowne, VA
National Provider Identifier
1073858601
Registry record updated Dec 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119005786 Issued in VA
Practice address
19465 Deerfield Ave
Suite 201
Lansdowne, VA 20176-1701
Phone
(703) 858-7620
Fax
(703) 858-7657
NPI assigned
Dec 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2012

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 0119005786 VA Primary

Addresses

Primary practice location

19465 Deerfield Ave
Suite 201
Lansdowne, VA 20176-1701

Mailing address

19465 Deerfield Ave
Suite 201
Lansdowne, VA 20176-1701
Phone (703) 858-7620

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0119005786VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1354924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354924800000",
    "number": "1073858601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19465 DEERFIELD AVE",
            "address_2": "SUITE 201",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201761701",
            "telephone_number": "703-858-7620",
            "fax_number": "703-858-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19465 DEERFIELD AVE",
            "address_2": "SUITE 201",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201761701",
            "telephone_number": "703-858-7620",
            "fax_number": "703-858-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILEY",
        "first_name": "CHERYLYNN",
        "middle_name": "PAGE",
        "name_prefix": "Mrs.",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-08",
        "last_updated": "2012-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdowne, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2012; 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.