Kimberly Dawn Shaw, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

952 Issued in OK

Practice address

811 E Virginia Ave
Stillwater, OK 74075-7919

Phone

(405) 377-8255

Fax

(405) 835-3920

NPI assigned

Dec 5, 2007

Last updated

May 2, 2022By the provider in NPPES

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

Other names 1

• Kimberly Dawn Newman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dysphagia Specialists, PLLC

  dba Therapy Specialists

  • Speech-Language Pathologist
  • Stillwater, OK
  • NPI 1356746184
  NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1417139007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15413 S CR 207",
            "city": "BLAIR",
            "state": "OK",
            "postal_code": "735269256",
            "telephone_number": "580-301-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E VIRGINIA AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740757919",
            "telephone_number": "405-377-8255",
            "fax_number": "405-835-3920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2002 E Robinson St",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730717420",
            "country_code": "US",
            "telephone_number": "405-307-2814",
            "fax_number": "405-307-2801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "NEWMAN",
            "middle_name": "DAWN",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Shaklee
• Shannon Bruey Pmhmp LLC
• Darian Nicole Sharp
• Jeannie Ann Sharpton
• Jesse Daniel Shaw, D.O
• Laura De Mauriac Shaw, ARNP
• Jack Shearer, DO
• Leigh Sheets
• Sheila J. Stanek, D.O., PC
• Laura Shellhammer, MS

• Occupational Therapy Assistant in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Occupational Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.