Individual provider Active NPI

Maya Shaanan, OTD

  • Occupational Therapist
  • Sparks, NV
National Provider Identifier
1205544814
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2880 Issued in NV
Practice address
2375 E Prater Way
Sparks, NV 89434-9641
Phone
(775) 331-7000
NPI assigned
Nov 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-2880 NV Primary

Addresses

Primary practice location

2375 E Prater Way
Sparks, NV 89434-9641

Mailing address

38 Calle del Norte
Placitas, NM 87043-9208
Phone (650) 248-8404

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

LicenseStateTypeSpecialty
OT-2880NVMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1205544814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 CALLE DEL NORTE",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870439208",
            "telephone_number": "650-248-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E PRATER WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349641",
            "telephone_number": "775-331-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAANAN",
        "first_name": "MAYA",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "OT-2880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.