Individual provider Active NPI

Shanon Suzanne Aarup

  • Occupational Therapy Assistant
  • Palm Desert, CA
National Provider Identifier
1346487758
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA807 Issued in CA
Practice address
77564 Country Club Dr Ste 340
Palm Desert, CA 92211-0450
Phone
(760) 772-2838
Fax
(760) 772-2883
NPI assigned
Jan 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA807 CA Primary

Addresses

Primary practice location

77564 Country Club Dr Ste 340
Palm Desert, CA 92211-0450

Mailing address

77564 Country Club Dr Ste 340
Palm Desert, CA 92211-0450
Phone (760) 772-2838

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@dot4kids.com

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

LicenseStateTypeSpecialty
OTA807CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Occupational Therapy for Kids Inc. PastSince Oct 25, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1346487758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77564 COUNTRY CLUB DR STE 340",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922110450",
            "telephone_number": "760-772-2838",
            "fax_number": "760-772-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77564 COUNTRY CLUB DR STE 340",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922110450",
            "telephone_number": "760-772-2838",
            "fax_number": "760-772-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AARUP",
        "first_name": "SHANON",
        "middle_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "OTA807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@dot4kids.com",
            "affiliation": "N",
            "address_1": "77564 Country Club Dr Ste 340",
            "city": "Palm Desert",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922110450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.