Active NPI
Alyssa Shirley, OTR/L
- Occupational Therapist
- Star, ID
National Provider Identifier
1285520536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6471866
- Practice address
- 12222 W Bridger Bay Dr
Star, ID 83669-5081 - Phone
- (208) 391-2773
- NPI assigned
- Jun 14, 2025
- 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 | 6471866 | ID | Primary |
Addresses
Primary practice location
12222 W Bridger Bay Dr
Star, ID 83669-5081
Mailing address
12222 W Bridger Bay Dr
Star, ID 83669-5081
Phone (208) 473-1098
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6471866 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Star Speech and Occupational Therapy LLC | Current | Accepting new patients |
Locations
12222 W Bridger Bay Dr
Star, ID 83669
Phone (208) 391-2773
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Star, ID
- NPI 1669917571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749859200000",
"number": "1285520536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12222 W BRIDGER BAY DR",
"city": "STAR",
"state": "ID",
"postal_code": "836695081",
"telephone_number": "208-473-1098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12222 W BRIDGER BAY DR",
"city": "STAR",
"state": "ID",
"postal_code": "836695081",
"telephone_number": "208-391-2773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "ALYSSA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-14",
"last_updated": "2025-06-14",
"certification_date": "2025-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "6471866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Star, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.