Individual provider Active NPI

Marci Wilkinson, OTR/L

  • Occupational Therapist
  • Shelbyville, KY
National Provider Identifier
1114476124
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
170906 Issued in KY
Practice address
90 Howard Dr
Shelbyville, KY 40065-8138
Phone
(502) 633-1007
Fax
(502) 437-0624
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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 170906 KY Primary

Addresses

Primary practice location

90 Howard Dr
Shelbyville, KY 40065-8138

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007

Other names 1

  • Marci Shutt Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200310001963 KY Practitioner - Occupational Therapist in Private Practice 9830527688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Kentucky, LLCGroup PAC ID 1850729211, 108 clinicians

Practice addresses (Care Compare)

1165 Monarch St
Lexington, KY 40513-1979
Phone (844) 502-7996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
170906KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Kentucky, LLC Occupational Therapist CurrentSince Feb 6, 2023 Accepting new patients
Empowerme Rehabilitation Kentucky, LLC CurrentSince Feb 6, 2023 Accepting new patients

Locations

115 Ashton Grove Path
Georgetown, KY 40324
Phone (502) 453-8605

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

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": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1114476124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-633-1007",
            "fax_number": "502-437-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-633-1007",
            "fax_number": "502-437-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "MARCI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "170906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCI",
            "last_name": "SHUTT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.