Shannon G Blandford, OTR/L
Individual provider Active NPI Occupational Therapist · Bowling Green, KY
NPI 1124287438 · NPPES record last updated Jun 3, 2008
Key facts
- NPI
- 1124287438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- KY-R2942 (KY)
- Practice address
- 2611 Cheyenne Dr
Bowling Green, KY 42104-4205 - Phone
- (270) 978-1297
- NPI assigned
- Jun 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Empowerme Rehabilitation Kentucky, LLC
Practice addresses (Care Compare)
1165 Monarch St
Lexington, KY 40513-1979
Phone (844) 502-7996
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250415003136 | KY | Practitioner - Occupational Therapist in Private Practice | 7113442823 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-R2942 | KY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerme Rehabilitation Kentucky, LLC | Occupational Therapist | Current |
Accepting new patients |
| Empowerme Rehabilitation Kentucky, LLC | Current |
Accepting new patients |
Locations
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | KY-R2942 | KY | Yes |
Addresses
Primary practice location
2611 Cheyenne Dr
Bowling Green, KY 42104-4205
Mailing address
2611 Cheyenne Dr
Bowling Green, KY 42104-4205
Phone (270) 978-1297
Other providers in Bowling Green, KY
- Logan Blackmon
- Cassandra Collette Blackwell
- Jamie Blair
- Kevin R Blalock
- Autumn Bland
- Alyzea Blankenship
- Kristin Marie Blankenship
- Maire M Blankenship
- Kendal Lashea Bledsoe
- Morgan Deann Blevins
All providers in Bowling Green, KY · Occupational Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.