Active NPI
Shannon Holt, OT
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1275503153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3358
- Practice address
- 2418 Blue Ridge Rd
Suite 100
Raleigh, NC 27607-6480 - Phone
- (919) 782-5954
- Fax
- (919) 859-9444
- NPI assigned
- Jan 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3358 | NC | Primary |
Addresses
Primary practice location
2418 Blue Ridge Rd
Suite 100
Raleigh, NC 27607-6480
Mailing address
3528 Wade Avenue
#139
Raleigh, NC 27607-4048
Phone (919) 782-5954
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13729 | Other | NC | BLUE CROSS BLUE SHIELD |
| 5947795 | Other | NC | AETNA |
| D9498 | Other | NC | MEDCOST |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness One, Inc | Occupational Therapist | Past | Accepting new patients |
| Bayada Home Health Care, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Home Health Agency
- Raleigh, NC
- NPI 1285876250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275503153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3528 WADE AVENUE",
"address_2": "#139",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276074048",
"telephone_number": "919-782-5954",
"fax_number": "919-859-9444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2418 BLUE RIDGE RD",
"address_2": "SUITE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076480",
"telephone_number": "919-782-5954",
"fax_number": "919-859-9444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "SHANNON",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "3358",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "13729",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5947795",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "D9498",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.