Individual provider Active NPI

Shoneisha M Nalley, COTA

  • Occupational Therapy Assistant
  • Titusville, FL
National Provider Identifier
1356908289
Registry record updated May 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
15194 Issued in FL
Practice address
1705 Jess Parrish CT
Titusville, FL 32796-2158
Phone
(386) 334-6141
NPI assigned
May 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2019

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 15194 FL Primary

Addresses

Primary practice location

1705 Jess Parrish CT
Titusville, FL 32796-2158

Mailing address

8585 Julia Marie Cir
Jacksonville, FL 32210-0413
Phone (904) 708-9491

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
15194FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1558915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558915200000",
    "number": "1356908289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 JULIA MARIE CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322100413",
            "telephone_number": "904-708-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 JESS PARRISH CT",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962158",
            "telephone_number": "386-334-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLEY",
        "first_name": "SHONEISHA",
        "middle_name": "M",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-27",
        "last_updated": "2019-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "15194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.