Shirley Jane Cain, COTA/L

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

OTA-O2618 Issued in OH

Practice address

5425 High Mill Ave NW
Massillon, OH 44646-9005

Phone

(330) 833-3174

Fax

(330) 833-4216

NPI assigned

Oct 20, 2011

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

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": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1386929495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 HIGH MILL AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469005",
            "telephone_number": "330-833-3174",
            "fax_number": "330-833-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 HIGH MILL AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469005",
            "telephone_number": "330-833-3174",
            "fax_number": "330-833-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "SHIRLEY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "OTA-O2618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Jeanne Burr
• Davina Burt
• Chancelor Bush
• Fred F. Butler, CDMS
• Daniel Joseph Cain, D.O.
• Fallon M Camp
• Mark Ej Campanale, CDCA
• Joseph Campanelli
• Connor Wayne Campbell, PT, DPT
• Kaitlin Elizabeth Campbell, FNP

• Community Health Worker in Massillon, OH
• Providers in Massillon, OH by specialty
• Community Health Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.