Individual provider Active NPI

Karen K Shambaugh, OTR/L

  • Occupational Therapist
  • Cumberland, MD
National Provider Identifier
1295002111
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
06809 Issued in MD
Practice address
217 Glenn St Ste 301
Cumberland, MD 21502-2590
Phone
(301) 777-2170
Fax
(301) 777-2173
NPI assigned
Nov 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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 06809 MD Primary

Addresses

Primary practice location

217 Glenn St Ste 301
Cumberland, MD 21502-2590

Mailing address

217 Glenn St Ste 301
Cumberland, MD 21502-2590
Phone (301) 722-2170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160404000820 WV Practitioner - Occupational Therapist in Private Practice 9931361417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
West Virginia University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
X-Cel Performance Rehab LLCGroup PAC ID 6608173877, 7 clinicians

Practice addresses (Care Compare)

4767 Frankfort Hwy
Ridgeley, WV 26753-7772
Phone (304) 738-4045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06809MDMDClinical Psychologist
1803WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
X-Cel Performance Rehab LLC CurrentSince Dec 9, 2015 Accepting new patients
The Hand Institute L.L.C. Occupational Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1295002111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 GLENN ST STE 301",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022590",
            "telephone_number": "301-722-2170",
            "fax_number": "301-777-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 GLENN ST STE 301",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022590",
            "telephone_number": "301-777-2170",
            "fax_number": "301-777-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBAUGH",
        "first_name": "KAREN",
        "middle_name": "K",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.