Individual provider Active NPI

Shanda Dawn, MS, OTR/L

  • Pediatric Occupational Therapist
  • Alexandria, VA
National Provider Identifier
1154746337
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
0119009526 Issued in VA
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

Updated by the provider on Oct 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0119009526VAMDPediatric 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.

Verify at the official NPI Registry.