Individual provider Active NPI

Erin L Martin, OTR

  • Occupational Therapist
  • Marion, IN
National Provider Identifier
1386717577
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31003878A Issued in IN
Practice address
4411 S Adams St
Marion, IN 46953-5349
Phone
(765) 674-4455
Fax
(765) 674-3577
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31003878A IN Primary

Addresses

Primary practice location

4411 S Adams St
Marion, IN 46953-5349

Mailing address

4411 S Adams St
Marion, IN 46953-5349
Phone (765) 674-4455

Other identifiers 2

IdentifierTypeStateIssuer
129137500OtherINUS DEPARTMENT OF LABOR
100124000MedicaidIN

Other names 1

  • Miss Erin L Sheridan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917000329 IN Practitioner - Occupational Therapist in Private Practice 7113345513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shmily Productions LLCGroup PAC ID 5092051672, 2 clinicians

Practice addresses (Care Compare)

1542 S Dixon Rd B
You'Re in Control!
Kokomo, IN 46902-7319
Phone (765) 319-8420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31003878AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shmily Productions LLC Occupational Therapist CurrentSince May 8, 2023 Accepting new patients

Locations

1542 S Dixon Rd
Ste B
Kokomo, IN 46902
Phone (765) 319-8420

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1386717577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 S ADAMS ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535349",
            "telephone_number": "765-674-4455",
            "fax_number": "765-674-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 S ADAMS ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535349",
            "telephone_number": "765-674-4455",
            "fax_number": "765-674-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ERIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31003878A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "129137500",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "SHERIDAN",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.