Jennise Elaine Shaw, OTD OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT25087 Issued in FL

Practice address

6834 Medical View LN
Zephyrhills, FL 33542-6615

Phone

(813) 783-3187

NPI assigned

Mar 6, 2024

Last updated

Mar 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

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.

• Sports and Orthopedic Rehabilitation Services, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Tampa, FL
  • NPI 1336539030
  Medicare reassignment NPD
• Sports and Orthopedic Rehabilitation Services Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Riverview, FL
  • NPI 1841981073
  NPD

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1417715392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 NETWORK PL APT 204A",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6834 MEDICAL VIEW LN",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335426615",
            "telephone_number": "813-783-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "JENNISE",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "OTD OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT25087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronit Shah, MD
• Novera Shahid, DO
• Khaled Shahrour, M.D.
• Mariam Sharaka
• Kimberly Nicole Sharp, CRPS
• SHCC Services, Inc. (Sunbelt Health Care Center of Zephyrhills)
• Mary Elizabeth Shea, PH.D.
• Sheridan Radiology Services of West Florida, Inc.
• Da Shi
• Lynne B Shidler, MASSAGE THERAPIST

• Occupational Therapist in Zephyrhills, FL
• Providers in Zephyrhills, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.