Individual provider Active NPI

Shelby Wallace- Barnaby

  • Occupational Therapist
  • Chandler, AZ
National Provider Identifier
1407424831
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1326 E Thompson Way
Chandler, AZ 85286-1470
Phone
(323) 719-1465
NPI assigned
Jun 13, 2021
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1326 E Thompson Way
Chandler, AZ 85286-1470

Mailing address

411 E Indian School Rd Apt 2038
Phoenix, AZ 85012-1880
Phone (323) 719-1465

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Arizona

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801003744 AZ Practitioner - Occupational Therapist in Private Practice 8820506751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

9050 E Brown Rd
Mesa, AZ 85207-4356
Phone 4802738813775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 7, 2025 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 7, 2025 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1407424831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E INDIAN SCHOOL RD APT 2038",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121880",
            "telephone_number": "323-719-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 E THOMPSON WAY",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861470",
            "telephone_number": "323-719-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE- BARNABY",
        "first_name": "SHELBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-13",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arizona",
            "affiliation": "N",
            "endpointDescription": "Arizona",
            "address_1": "411 E Indian School Rd Apt 2038",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850121880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.