Individual provider Active NPI

Shacuyler D'Asia Huff, OTR/L

  • Pediatric Occupational Therapist
  • Lawrenceville, GA
National Provider Identifier
1104511005
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT008810 Issued in GA
Practice address
2387 Huntcrest Way
Lawrenceville, GA 30043-8126
Phone
(678) 648-7644
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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 OT008810 GA Primary

Addresses

Primary practice location

2387 Huntcrest Way
Lawrenceville, GA 30043-8126

Mailing address

6505 Shiloh Rd Ste 100
Alpharetta, GA 30005-1645
Phone (678) 648-7644

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
OT008810GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Pathways Comprehensive Therapy, LLC PastSince Apr 1, 2023 Accepting new patients
Therapyland LLC Pediatrics 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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1104511005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 SHILOH RD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051645",
            "telephone_number": "678-648-7644",
            "fax_number": "678-882-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 HUNTCREST WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438126",
            "telephone_number": "678-648-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFF",
        "first_name": "SHACUYLER",
        "middle_name": "D'ASIA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT008810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.