Active NPI
Donna Jean Shilts-Maresh, O.T.R.
- Occupational Therapist
- Canby, OR
National Provider Identifier
1114950755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 586
- Practice address
- 13601 S Union Hall Rd
Canby, OR 97013-9757 - Phone
- (503) 866-3304
- Fax
- (503) 632-8581
- NPI assigned
- Jul 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 000586 | OR | |
| Occupational Therapist | 225X00000X | 586 | OR | Primary |
Addresses
Primary practice location
13601 S Union Hall Rd
Canby, OR 97013-9757
Mailing address
13601 S Union Hall Rd
Canby, OR 97013-9757
Phone (503) 866-3304
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 158669 | Medicaid | OR |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 586 | OR | MD | Occupational Therapist |
| 000586 | OR | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Specialists I, LLC | Occupational Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1114950755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13601 S UNION HALL RD",
"city": "CANBY",
"state": "OR",
"postal_code": "970139757",
"telephone_number": "503-866-3304",
"fax_number": "503-632-8581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13601 S UNION HALL RD",
"city": "CANBY",
"state": "OR",
"postal_code": "970139757",
"telephone_number": "503-866-3304",
"fax_number": "503-632-8581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHILTS-MARESH",
"first_name": "DONNA",
"middle_name": "JEAN",
"credential": "O.T.R.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-08",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "OR",
"license": "000586",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158669",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.