Individual provider Active NPI

Sheila K Mullen, OT

  • Occupational Therapist
  • Ankeny, IA
National Provider Identifier
1114465929
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
00557 Issued in IA
Practice address
2006 S Ankeny Blvd BLDG 5
Ankeny, IA 50023-8995
Phone
(515) 289-9541
Fax
(515) 446-3642
NPI assigned
Feb 1, 2017
Last updated
Mar 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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 00557 IA Primary

Addresses

Primary practice location

2006 S Ankeny Blvd BLDG 5
Ankeny, IA 50023-8995

Mailing address

1200 Pleasant St
South 2 Room 236
Des Moines, IA 50309-1406
Phone (515) 241-6228

Other identifiers 1

IdentifierTypeStateIssuer
1114465929MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170227000598 IA Practitioner - Occupational Therapist in Private Practice 1355625922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00557IAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Younker Rehabilitation Therapy Services, LLC Occupational Therapist CurrentSince Jul 1, 2017 Accepting new patients

Locations

2006 S Ankeny Blvd
Bldg 5
Ankeny, IA 50023
Phone (515) 289-9541

1200 Pleasant St
Rm 236
Des Moines, IA 50309
Phone (515) 241-6228

3200 Grand Ave
Des Moines, IA 50312
Phone (515) 271-1700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1114465929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "address_2": "SOUTH 2 ROOM 236",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-6228",
            "fax_number": "515-241-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 S ANKENY BLVD BLDG 5",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500238995",
            "telephone_number": "515-289-9541",
            "fax_number": "515-446-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "SHEILA",
        "middle_name": "K",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "00557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114465929",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.