Sterling Jerel Shores

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

74 Journey Way
Valparaiso, IN 46383-0078

Phone

(192) 554-3782

NPI assigned

Mar 26, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1366684086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6654 W 158TH LN",
            "city": "LOWELL",
            "state": "IN",
            "postal_code": "463564407",
            "telephone_number": "219-798-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 JOURNEY WAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463830078",
            "telephone_number": "192-554-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORES",
        "first_name": "STERLING",
        "middle_name": "JEREL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-26",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "31004741A",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "OT00004190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.