Active NPI
Shelly Herrmann, OTR/L
- Occupational Therapist
- Andover, KS
National Provider Identifier
1376826065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17-01618
- Practice address
- 516 W Jamestown CT
Andover, KS 67002-8834 - Phone
- (316) 733-2610
- NPI assigned
- Sep 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17-01618 | KS | Primary |
Addresses
Primary practice location
516 W Jamestown CT
Andover, KS 67002-8834
Mailing address
1266 SE Bluestem Rd
El Dorado, KS 67042-8823
Phone (316) 775-6904
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-01618 | KS | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adaptive Living, LLC | Occupational Therapist | Past | 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.
-
- Occupational Therapist
- Wichita, KS
- NPI 1093958712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1376826065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1266 SE BLUESTEM RD",
"city": "EL DORADO",
"state": "KS",
"postal_code": "670428823",
"telephone_number": "316-775-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 W JAMESTOWN CT",
"city": "ANDOVER",
"state": "KS",
"postal_code": "670028834",
"telephone_number": "316-733-2610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRMANN",
"first_name": "SHELLY",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-20",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "17-01618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.