Active NPI
Shainna Davis, OTR/L
- Occupational Therapist
- Havertown, PA
National Provider Identifier
1124432851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC01079
- Practice address
- 1617 Woodmere Way
Havertown, PA 19083-2509 - Phone
- (610) 316-5842
- NPI assigned
- Jun 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC01079 | PA | Primary |
Addresses
Primary practice location
1617 Woodmere Way
Havertown, PA 19083-2509
Mailing address
1617 Woodmere Way
Havertown, PA 19083-2509
Phone (610) 316-5842
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC01079 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1124432851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1617 WOODMERE WAY",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190832509",
"telephone_number": "610-316-5842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 WOODMERE WAY",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190832509",
"telephone_number": "610-316-5842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SHAINNA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-20",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC01079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havertown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.