Judith Amber Shackleton, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

134527 Issued in KY

Practice address

100 Envoy Cir Unit 101
Louisville, KY 40299-1807

Phone

(502) 896-5669

NPI assigned

Oct 23, 2019

Last updated

Oct 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Judy A Shackleton Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Core Chiropractic Inc

  • Chiropractor
  • Louisville, KY
  • NPI 1699552240
  NPD

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1326681107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8323 REGENCY WOODS WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402203817",
            "telephone_number": "502-548-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ENVOY CIR UNIT 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991807",
            "telephone_number": "502-896-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLETON",
        "first_name": "JUDITH",
        "middle_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "134527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "SHACKLETON",
            "middle_name": "A",
            "prefix": "MRS.",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kourtnee Seymour, LPCC
• Leslie Elise Seymour
• Hannah M Shaaban, LCSW
• Christopher Brandon Shaaber
• Tori Shaak-Johnston, APRN
• Thomas J Shacklette, RPH
• Shaconya L Richardson
• Jessica D Shadburne, CRNA
• Haley Shadday, OTR
• Alyssa Shaddox

• Occupational Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.