Active NPI
Shelby Cornwell
- Occupational Therapy Assistant
- Arden, NC
National Provider Identifier
1487313656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 11855
- Practice address
- 3864 Sweeten Creek Rd
Arden, NC 28704-3136 - Phone
- (828) 681-0904
- NPI assigned
- Dec 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | |||
| Occupational Therapy Assistant | 224Z00000X | 11855 | NC | Primary |
Addresses
Primary practice location
3864 Sweeten Creek Rd
Arden, NC 28704-3136
Mailing address
307 Ballantyne Common Cir Apt 203
Hendersonville, NC 28792-7572
Phone (252) 342-8110
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 |
|---|---|---|---|
| 11855 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1487313656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 BALLANTYNE COMMON CIR APT 203",
"city": "HENDERSONVILLE",
"state": "NC",
"postal_code": "287927572",
"telephone_number": "252-342-8110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3864 SWEETEN CREEK RD",
"city": "ARDEN",
"state": "NC",
"postal_code": "287043136",
"telephone_number": "828-681-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNWELL",
"first_name": "SHELBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-14",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "11855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.