Active NPI
Shanda Dawn, MS, OTR/L
- Pediatric Occupational Therapist
- Alexandria, VA
National Provider Identifier
1154746337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 0119009526
- Practice address
- 5695 King Centre Dr Ste 100
Alexandria, VA 22315-5745 - Phone
- (571) 303-1298
- NPI assigned
- Feb 25, 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 0119009526 | VA | Primary |
Addresses
Primary practice location
5695 King Centre Dr Ste 100
Alexandria, VA 22315-5745
Mailing address
4111 Steeds Grant Way
Fort Washington, MD 20744-1401
Phone (301) 526-5814
Other practice location 1
4111 Steeds Grant Way
Fort Washington, MD 20744-1401
Phone (301) 526-5814
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119009526 | VA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1154746337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 STEEDS GRANT WAY",
"city": "FORT WASHINGTON",
"state": "MD",
"postal_code": "207441401",
"telephone_number": "301-526-5814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5695 KING CENTRE DR STE 100",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223155745",
"telephone_number": "571-303-1298"
}
],
"practiceLocations": [
{
"address_1": "4111 Steeds Grant Way",
"address_purpose": "LOCATION",
"city": "Fort Washington",
"state": "MD",
"postal_code": "207441401",
"country_code": "US",
"telephone_number": "301-526-5814",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAWN",
"first_name": "SHANDA",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-25",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "VA",
"license": "0119009526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.