Active NPI
Kathleen Duke Shaffer, OTR-L
- Occupational Therapist
- Pflugerville, TX
National Provider Identifier
1477501377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 111233
- Practice address
- 2415 W Pecan St #100
Pflugerville, TX 78660-3670 - Phone
- (512) 251-3230
- Fax
- (512) 251-8760
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 111233 | TX | |
| Occupational Therapist | 225X00000X | 111233 | TX | Primary |
Addresses
Primary practice location
2415 W Pecan St #100
Pflugerville, TX 78660-3670
Mailing address
2415 W Pecan St #100
Pflugerville, TX 78660-3670
Phone (512) 251-3230
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176646101 | Medicaid | TX | |
| 8T6897 | Other | TX | BCBS |
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 |
|---|---|---|---|
| 111233 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kathleen D. Shaffer LLC | Pediatrics | Past | Accepting new patients |
| OT Connection | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Pflugerville, TX
- NPI 1952734196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1477501377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 W PECAN ST #100",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603670",
"telephone_number": "512-251-3230",
"fax_number": "512-251-8760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 W PECAN ST #100",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603670",
"telephone_number": "512-251-3230",
"fax_number": "512-251-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "KATHLEEN",
"middle_name": "DUKE",
"name_prefix": "Mrs.",
"credential": "OTR-L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "111233",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "111233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "176646101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8T6897",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pflugerville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.