Active NPI
Joanne M Shannon
- Pediatric Occupational Therapist
- Orchard Park, NY
National Provider Identifier
1295981678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 006230
- Practice address
- 40 Centre Dr
Orchard Park, NY 14127-4100 - Phone
- (716) 667-2294
- Fax
- (716) 667-2272
- NPI assigned
- Aug 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 006230 | NY | Primary |
Addresses
Primary practice location
40 Centre Dr
Orchard Park, NY 14127-4100
Mailing address
677 McKinley Pkwy
Buffalo, NY 14220-1521
Phone (716) 864-9238
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006230 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268697600000",
"number": "1295981678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "677 MCKINLEY PKWY",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142201521",
"telephone_number": "716-864-9238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 CENTRE DR",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141274100",
"telephone_number": "716-667-2294",
"fax_number": "716-667-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "JOANNE",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-17",
"last_updated": "2010-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "006230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orchard Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.