Individual provider Active NPI

Shenicki Coleman Moore

  • Occupational Therapist
  • Katy, TX
National Provider Identifier
1336629708
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
116327 Issued in TX
Practice address
810 S Mason Rd
Katy, TX 77450-3895
Phone
(281) 652-5200
Fax
(818) 357-2505
NPI assigned
Aug 15, 2018
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 28310 CA
Occupational Therapist 225X00000X OT-2804 NV
Occupational Therapist 225X00000X 116327 TX Primary
Occupational Therapist 225X00000X OT.0009117 CO

Addresses

Primary practice location

810 S Mason Rd
Katy, TX 77450-3895

Mailing address

3540 Valmont Ave
Beaumont, TX 77706-6730
Phone (601) 665-8117

Other practice location 1

599 S Barranca Ave Ste 555
Covina, CA 91723-2791
Phone (818) 894-2273

Other practice location 2

6420 Wilshire Blvd Ste 600
Los Angeles, CA 90048-5521
Phone (818) 894-2273

Other practice location 3

3356 W Ball Rd Ste 219
Anaheim, CA 92804-3728
Phone (818) 894-2273

Other practice location 4

8929 Aero Dr Ste E
San Diego, CA 92123-2231
Phone (858) 277-2277

Other practice location 5

3540 Valmont Ave
Beaumont, TX 77706-6730
Phone (601) 665-8117

Other practice location 6

4300 Long Beach Blvd Ste 700
Long Beach, CA 90807-2000
Phone (818) 894-2273

Other practice location 7

5806 Pacific Blvd
Huntington Park, CA 90255-2618
Phone (818) 894-2273

Other practice location 8

1306 E Calvada Blvd
Pahrump, NV 89048-2797
Phone (818) 894-2273

Other practice location 9

3920 W Charleston Blvd Ste Y
Las Vegas, NV 89102-1633
Phone (818) 894-2273

Other practice location 10

6320 Canoga Ave Fl 15
Woodland Hills, CA 91367-2563
Phone (818) 894-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NV, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240723000345 TX Practitioner - Occupational Therapist in Private Practice 3577009927 Reassigns benefits to 1 organization
I20241016000665 NV Practitioner - Occupational Therapist in Private Practice 3577009927 Reassigns benefits to 1 organization
I20260610000579 CA Practitioner - Occupational Therapist in Private Practice 3577009927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3540 Valmont Ave
Beaumont, TX 77706-6730

6320 Canoga Ave
FL 15
Woodland Hills, CA 91367-2593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Slptele LLC Occupational Therapist CurrentSince Jul 11, 2024 Accepting new patients

Locations

25101 The Old Rd
Stevenson Ranch, CA 91381
Phone (661) 230-8701

6320 Canoga Ave
Fl 15
Woodland Hls, CA 91367
Phone (818) 588-4003

601 N Pecos Rd
Las Vegas, NV 89101
Phone (702) 455-2202

1306 E Calvada Blvd
Pahrump, NV 89048
Phone (702) 339-8770

9600 Great Hills Trl
Ste 150E
Austin, TX 78759

2626 Cole Ave
Ste 300
Dallas, TX 75204
Phone (469) 340-1849

20333 State Highway 249
Ste 200
Houston, TX 77070
Phone (281) 748-9088

2717 Commercial Center Blvd
Ste E200
Katy, TX 77494
Phone (281) 865-5433

810 S Mason Rd
Ste 315
Katy, TX 77450
Phone (281) 652-5200

11200 Broadway St
Ste 2743
Pearland, TX 77584
Phone (281) 818-6758

18756 Stone Oak Pkwy
Ste 200
San Antonio, TX 78258
Phone (210) 241-7562

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1336629708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 VALMONT AVE",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777066730",
            "telephone_number": "601-665-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MASON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774503895",
            "telephone_number": "281-652-5200",
            "fax_number": "818-357-2505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "599 S Barranca Ave Ste 555",
            "address_purpose": "LOCATION",
            "city": "Covina",
            "state": "CA",
            "postal_code": "917232791",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6420 Wilshire Blvd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485521",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3356 W Ball Rd Ste 219",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928043728",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8929 Aero Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921232231",
            "country_code": "US",
            "telephone_number": "858-277-2277",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3540 Valmont Ave",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777066730",
            "country_code": "US",
            "telephone_number": "601-665-8117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Long Beach Blvd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908072000",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5806 Pacific Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "902552618",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1306 E Calvada Blvd",
            "address_purpose": "LOCATION",
            "city": "Pahrump",
            "state": "NV",
            "postal_code": "890482797",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3920 W Charleston Blvd Ste Y",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021633",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6320 Canoga Ave Fl 15",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913672563",
            "country_code": "US",
            "telephone_number": "818-894-2273",
            "fax_number": "818-357-2505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHENICKI",
        "middle_name": "COLEMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "28310",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "OT-2804",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116327",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0009117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.