Active NPI
Shawn Peters-Blascyk
- Occupational Therapist
- Liberal, KS
National Provider Identifier
1174725733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1702250
- Practice address
- 2160 Zinnia LN
Liberal, KS 67901-2042 - Phone
- (615) 896-6400
- NPI assigned
- Jun 4, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1702250 | KS | Primary |
Addresses
Primary practice location
2160 Zinnia LN
Liberal, KS 67901-2042
Mailing address
106 Cambridge CT
Garden City, KS 67846-9662
Phone (620) 260-9059
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 |
|---|---|---|---|
| 1702250 | KS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174725733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 CAMBRIDGE CT",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678469662",
"telephone_number": "620-260-9059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 ZINNIA LN",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679012042",
"telephone_number": "615-896-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS-BLASCYK",
"first_name": "SHAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "1702250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberal, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.