Active NPI
Shannon Deal, COTA/L
- Occupational Therapy Assistant
- Portsmouth, VA
National Provider Identifier
1518625243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 0131-002591
- Practice address
- 4201 Greenwood Dr
Portsmouth, VA 23701-3250 - Phone
- (757) 654-1444
- NPI assigned
- Nov 30, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 0131-002591 | VA | Primary |
Addresses
Primary practice location
4201 Greenwood Dr
Portsmouth, VA 23701-3250
Mailing address
4201 Greenwood Dr
Portsmouth, VA 23701-3250
Phone (757) 654-1444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0131-002591 | Other | VA | VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS |
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 |
|---|---|---|---|
| 0131-002591 | VA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1518625243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 GREENWOOD DR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237013250",
"telephone_number": "757-654-1444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 GREENWOOD DR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237013250",
"telephone_number": "757-654-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAL",
"first_name": "SHANNON",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-30",
"last_updated": "2021-11-30",
"certification_date": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VA",
"license": "0131-002591",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS",
"identifier": "0131-002591",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.