Individual provider Active NPI

Shannon Wrobel, OTR

  • Occupational Therapist
  • Long Island City, NY
National Provider Identifier
1245823525
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025292-01 Issued in NY
Practice address
2810 Jackson Ave Apt 32N
Long Island City, NY 11101-3168
Phone
(516) 384-4514
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 025292-01 NY Primary

Addresses

Primary practice location

2810 Jackson Ave Apt 32N
Long Island City, NY 11101-3168

Mailing address

2810 Jackson Ave Apt 32N
Long Island City, NY 11101-3168
Phone (516) 384-4514

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
025292-01NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1245823525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 JACKSON AVE APT 32N",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013168",
            "telephone_number": "516-384-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 JACKSON AVE APT 32N",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013168",
            "telephone_number": "516-384-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROBEL",
        "first_name": "SHANNON",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025292-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.