Shannon Dale Miller, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT21162 Issued in FL

Practice address

6400 Edgelake Dr
Sarasota, FL 34240-8813

Phone

(941) 921-8600

NPI assigned

Apr 15, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1194579466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 27TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053846",
            "telephone_number": "941-705-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 EDGELAKE DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342408813",
            "telephone_number": "941-921-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHANNON",
        "middle_name": "DALE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT21162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Randall Miller
• Pamela Gail Miller, M.A.
• Robert D Miller, D.M.D.
• Roger Miller, O.D.
• Serena Chantee Miller
• Sharon Teresa Miller, PHARMD
• Susan B Miller, M.A.
• Joseph C. Millin Jr., D.O.
• Ashley Mills, M.S., CCC-SLP
• Jaime Noelle Mills, PA-C

• Occupational Therapist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.