Individual provider Active NPI

Emily Ann Sheridan, OT

  • Feeding, Eating & Swallowing Occupational Therapist
  • Kent, WA
National Provider Identifier
1407259088
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Feeding, Eating & Swallowing Occupational TherapistTaxonomy code 225XF0002X
License
OT60433863 Issued in WA
Practice address
10811 SE Kent Kangley Rd
Kent, WA 98030-7108
Phone
(253) 854-5660
Fax
(253) 854-7025
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT60433863 WA
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X OT60433863 WA Primary
Pediatric Occupational Therapist 225XP0200X OT60433863 WA

Addresses

Primary practice location

10811 SE Kent Kangley Rd
Kent, WA 98030-7108

Mailing address

10811 SE Kent Kangley Rd
Kent, WA 98030-7108
Phone (253) 854-5660

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

LicenseStateTypeSpecialty
OT60433863WAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1407259088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 SE KENT KANGLEY RD",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307108",
            "telephone_number": "253-854-5660",
            "fax_number": "253-854-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10811 SE KENT KANGLEY RD",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307108",
            "telephone_number": "253-854-5660",
            "fax_number": "253-854-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60433863",
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "WA",
            "license": "OT60433863",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT60433863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.