Organization Active NPI

My-E-Therapy LLC

  • Occupational Therapist
  • Terre Haute, IN
National Provider Identifier
1245861855
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MY-E-THERAPY LLC
Practice address
4790 E Brentview Ave
Terre Haute, IN 47805-9776
Phone
(812) 239-5355
NPI assigned
Feb 1, 2020
Last updated
Apr 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Shelby Bennett, MS,OTR/LNPI 1205323425
Title
Owner
Phone
(812) 239-5355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

4790 E Brentview Ave
Terre Haute, IN 47805-9776

Mailing address

4790 E Brentview Ave
Terre Haute, IN 47805-9776
Phone (812) 239-5355

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL TerraHaute

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1245861855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 E BRENTVIEW AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478059776",
            "telephone_number": "812-239-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 E BRENTVIEW AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478059776",
            "telephone_number": "812-239-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY-E-THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-01",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-239-5355",
        "authorized_official_credential": "MS,OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "TerraHaute",
            "affiliation": "N",
            "address_1": "4790 E Brentview Ave",
            "city": "Terre Haute",
            "state": "IN",
            "country_code": "US",
            "postal_code": "478059776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.