Shannon Lynn Gulledge, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

7311309 Issued in NY

Practice address

6733 N Spring Wagon Dr
Tucson, AZ 85743-8669

Phone

(585) 331-0209

NPI assigned

Nov 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1255705141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6733 N SPRING WAGON DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857438669",
            "telephone_number": "585-331-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6733 N SPRING WAGON DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857438669",
            "telephone_number": "585-331-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEDGE",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "7311309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY ASSISTANT LICENSE",
            "identifier": "6085",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Carlos Guimbarda, MD
• Ashley Danielle Guinn, MD
• Hannah Lee Guinn, PA-C
• Kylie Shea Guinta
• John Guisto, MD
• Caitlin Gullette
• Nicole M Gullick, M.D.
• Crystal Gulotta, DNP, CNM, FNP
• Jazilyn Gulotta, RN
• Rhodelia Jane Gumangan, D.D.S.

• Occupational Therapy Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Occupational Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.