Active NPI
Shane Ball, COTA
- Occupational Therapy Assistant
- Ellsworth, ME
National Provider Identifier
1437715034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OA3627
- Practice address
- 190 Bangor Rd
Ellsworth, ME 04605-3258 - Phone
- (207) 667-7108
- Fax
- (207) 664-0461
- NPI assigned
- May 20, 2019
- Last updated
- May 20, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | OA3627 | ME | Primary |
Addresses
Primary practice location
190 Bangor Rd
Ellsworth, ME 04605-3258
Mailing address
190 Bangor Rd
Ellsworth, ME 04605-3258
Phone (207) 667-7108
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | shane.ball@maine.gov | Direct |
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 |
|---|---|---|---|
| OA3627 | ME | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1437715034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 BANGOR RD",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046053258",
"telephone_number": "207-667-7108",
"fax_number": "207-664-0461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 BANGOR RD",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046053258",
"telephone_number": "207-667-7108",
"fax_number": "207-664-0461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALL",
"first_name": "SHANE",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "ME",
"license": "OA3627",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "shane.ball@maine.gov",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "190 Bangor Rd",
"city": "Ellsworth",
"state": "ME",
"country_code": "US",
"postal_code": "046053258",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ellsworth, ME
- Karen Shea Arkin, BHP, MHRT-C, CADC
- Elizabeth Arntzen, LMT
- Audiology Center of Maine, LLC, PA
- Audiology Center, LLC (Audiology Center of Maine)
- Christine Bagley, MHRT-CSP
- Barbara E. Bland, LLC
- Elizabeth Barbato, MHRT-CSP
- Jessica Barbay, O.D.
- Bay View Physical Therapy Limited Partnership
- Bayview Center for Mental Health
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.