Individual provider Active NPI

Shawna Angelo, OT

  • Occupational Therapist
  • Delta, CO
National Provider Identifier
1104137926
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1061336 Issued in CO
Practice address
2050 S Main St
Delta, CO 81416-2407
Phone
(970) 874-9773
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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 1061336 CO Primary

Addresses

Primary practice location

2050 S Main St
Delta, CO 81416-2407

Mailing address

9650 2150 Rd
Austin, CO 81410-8345
Phone (970) 835-4611

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

LicenseStateTypeSpecialty
1061336COMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1104137926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 2150 RD",
            "city": "AUSTIN",
            "state": "CO",
            "postal_code": "814108345",
            "telephone_number": "970-835-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 S MAIN ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814162407",
            "telephone_number": "970-874-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "SHAWNA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "1061336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.