Shannon Faith Wichman, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

018960 Issued in NY

Practice address

25 Little Plains Rd
Huntington, NY 11743-4550

Phone

(631) 266-4441

NPI assigned

Jul 17, 2014

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• New York Therapy Placement Services

  • Early Intervention Provider Agency
  • Port Jefferson Station, NY
  • NPI 1982060489
  NPD (past)

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1467869818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 WILDWOOD DR",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117892143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LITTLE PLAINS RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434550",
            "telephone_number": "631-266-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 Nesconset Hwy",
            "address_2": "Suite 30",
            "address_purpose": "LOCATION",
            "city": "Port Jeff Sta",
            "state": "NY",
            "postal_code": "117762053",
            "country_code": "US",
            "telephone_number": "631-473-4284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICHMAN",
        "first_name": "SHANNON",
        "middle_name": "FAITH",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OT LICENSE",
            "identifier": "018960",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Wenzel, MHC
• Wesley Beth Reiss D O P C
• West Carver Medical Assoc
• West Hills Chiropractic Pain PC
• Sherrie Wharton, OTR/L
• William a Healy III MD PC
• William J Weissinger DPM PC
• William Joseph Vanvynck Physical Therapy, P.C.
• Alicia Rena Williams-Hickson, LMSW
• Rouschan Williams

• Occupational Therapist in Huntington, NY
• Providers in Huntington, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.