Shelby Marie Stark, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2012018295 Issued in MO

Practice address

2400 Veterans Memorial Dr
Cape Girardeau, MO 63701-9620

Phone

(573) 290-5870

NPI assigned

May 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelby Marie Hotop Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1366299802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 PCR 912",
            "city": "SAINT MARY",
            "state": "MO",
            "postal_code": "636737113",
            "telephone_number": "573-768-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 VETERANS MEMORIAL DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637019620",
            "telephone_number": "573-290-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "SHELBY",
        "middle_name": "MARIE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2012018295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "HOTOP",
            "middle_name": "MARIE",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Stahr, M.D.
• Laura Ziegler Standridge, MSN, APRN, FNP-BC
• Julia M Stanley, MD
• Michelle R Stanley
• Janice R Starek, CRNA
• Taylor McKenzie Stark, FNP
• Starla Lee Dba Authentic Touch Direct Care Services
• State of Missouri
• Judy K. Statler, LPC
• Jeffrey Scott Steele, M.D.

• Occupational Therapy Assistant in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.