Individual provider Active NPI

Shannon Chertkoev, OTR

  • Occupational Therapist
  • Dallas, TX
National Provider Identifier
1346190816
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
9714 Hathaway St
Dallas, TX 75220-2114
Phone
(240) 586-4130
NPI assigned
Feb 2, 2026
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 Primary

Addresses

Primary practice location

9714 Hathaway St
Dallas, TX 75220-2114

Mailing address

9714 Hathaway St
Dallas, TX 75220-2114
Phone (240) 586-4130

Other names 1

  • Shannon Neal Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260213000480 TX Practitioner - Occupational Therapist in Private Practice 8022598606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

5855 Milton St
Dallas, TX 75206-4202
Phone (216) 374-6220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120515TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Care Southeast, LLC Occupational Therapist CurrentSince Jan 6, 2026 Accepting new patients

Locations

127 W Broad St
Ste 850
Lake Charles, LA 70601
Phone (337) 310-8500

Organizations & group practices 1

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": "1769990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1346190816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9714 HATHAWAY ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752202114",
            "telephone_number": "240-586-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9714 HATHAWAY ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752202114",
            "telephone_number": "240-586-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERTKOEV",
        "first_name": "SHANNON",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-02",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "NEAL",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.