Active NPI
Shannon Kumari Michener, MS, OTR
- Occupational Therapist
- Lebanon, IN
National Provider Identifier
1316101280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003383A
- Practice address
- 1001 N Grant St
Lebanon, IN 46052-1944 - Phone
- (765) 482-6400
- NPI assigned
- Jul 10, 2008
- 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 | 31003383A | IN | Primary |
Addresses
Primary practice location
1001 N Grant St
Lebanon, IN 46052-1944
Mailing address
2601 Dover CT
Lebanon, IN 46052-8822
Phone (765) 438-7225
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31003383A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215648000000",
"number": "1316101280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 DOVER CT",
"city": "LEBANON",
"state": "IN",
"postal_code": "460528822",
"telephone_number": "765-438-7225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N GRANT ST",
"city": "LEBANON",
"state": "IN",
"postal_code": "460521944",
"telephone_number": "765-482-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHENER",
"first_name": "SHANNON",
"middle_name": "KUMARI",
"credential": "MS, OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-10",
"last_updated": "2008-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003383A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.