Individual provider Active NPI

Sheila Mick, OTR/L

  • Pediatric Occupational Therapist
  • Phoenix, AZ
National Provider Identifier
1265674808
Registry record updated Aug 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
2796 Issued in AZ
Practice address
4045 E Union Hills Dr Ste 110
Phoenix, AZ 85050
Phone
(602) 485-4444
NPI assigned
Mar 27, 2009
Last updated
Aug 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 2796 AZ Primary

Addresses

Primary practice location

4045 E Union Hills Dr Ste 110
Phoenix, AZ 85050

Mailing address

4045 E Union Hills Dr Ste 110
Phoenix, AZ 85050-3389
Phone (602) 485-4444

Other practice location 1

4536 W Joshua Blvd
Chandler, AZ 85226-2037
Phone (480) 227-5436

Other identifiers 1

IdentifierTypeStateIssuer
612003MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811000486 AZ Practitioner - Occupational Therapist in Private Practice 5193797009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Therapy Services, Inc Occupational Therapist CurrentSince Jul 1, 2018 Accepting new patients
Sunrise Therapy Services, Inc Occupational Therapist CurrentSince Feb 18, 2024 Accepting new patients

Locations

4045 E Union Hills Dr
Ste 110
Phoenix, AZ 85050
Phone (602) 485-4444

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534636800000",
    "number": "1265674808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 E UNION HILLS DR STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850503389",
            "telephone_number": "602-485-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E UNION HILLS DR STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85050",
            "telephone_number": "602-485-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4536 W Joshua Blvd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852262037",
            "country_code": "US",
            "telephone_number": "480-227-5436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICK",
        "first_name": "SHEILA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2018-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "2796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612003",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2018; 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.