Active NPI
Shelby Mehlberg
- Occupational Therapy Assistant
- Redfield, SD
National Provider Identifier
1376909408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 079405
- Practice address
- 1015 E 3Rd St
Redfield, SD 57469-1402 - Phone
- (605) 472-2288
- NPI assigned
- Jan 5, 2016
- 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 Therapy Assistant | 224Z00000X | 079405 | IA | Primary |
Addresses
Primary practice location
1015 E 3Rd St
Redfield, SD 57469-1402
Mailing address
PO Box 84
Raymond, SD 57258-0084
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
| License | State | Type | Specialty |
|---|---|---|---|
| 079405 | IA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1376909408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 84",
"city": "RAYMOND",
"state": "SD",
"postal_code": "572580084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 E 3RD ST",
"city": "REDFIELD",
"state": "SD",
"postal_code": "574691402",
"telephone_number": "605-472-2288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHLBERG",
"first_name": "SHELBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-05",
"last_updated": "2021-05-17",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IA",
"license": "079405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redfield, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.