Individual provider Active NPI

Courtney Shaeffer, OTR/L, IBCLC

  • Occupational Therapist
  • Chugiak, AK
National Provider Identifier
1255730594
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
132372 Issued in AK
Practice address
22502 Sambar Loop
Chugiak, AK 99567-5377
Phone
(907) 762-4663
NPI assigned
Aug 21, 2014
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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 132372 AK Primary

Addresses

Primary practice location

22502 Sambar Loop
Chugiak, AK 99567-5377

Mailing address

7350 N Esther Drive
Palmer, AK 99645
Phone (701) 527-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220221001497 AK Practitioner - Occupational Therapist in Private Practice 3870714249 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1083WYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Health and Home LLC CurrentSince Dec 1, 2021 Accepting new patients
Top Therapy, PC Occupational Therapist PastSince Jan 17, 2021 Accepting new patients

Locations

1700 E Bogard Rd
Ste A200
Wasilla, AK 99654
Phone (907) 290-9595

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1255730594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 N ESTHER DRIVE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "701-527-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22502 SAMBAR LOOP",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995675377",
            "telephone_number": "907-762-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAEFFER",
        "first_name": "COURTNEY",
        "credential": "OTR/L, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "132372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chugiak, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.