Active NPI
Shannon Wilson
- Occupational Therapy Assistant
- Highland Heights, OH
National Provider Identifier
1396313995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 007485
- Practice address
- 403 Golf View Lane
Highland Heights, OH 44143 - Phone
- (440) 231-4222
- NPI assigned
- Jun 11, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 007485 | OH | Primary |
Addresses
Primary practice location
403 Golf View Lane
Highland Heights, OH 44143
Mailing address
402 Golfview LN
Highland Heights, OH 44143-4414
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 |
|---|---|---|---|
| 007485 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1396313995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 GOLFVIEW LN",
"city": "HIGHLAND HEIGHTS",
"state": "OH",
"postal_code": "441434414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 GOLF VIEW LANE",
"city": "HIGHLAND HEIGHTS",
"state": "OH",
"postal_code": "44143",
"telephone_number": "440-231-4222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-11",
"last_updated": "2021-06-11",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OH",
"license": "007485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.