Active NPI
Shelby Lynn Otto, OT
- Occupational Therapist
- Waukesha, WI
National Provider Identifier
1548830995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7009-26
- Practice address
- 1604 Legend Hill LN
Waukesha, WI 53189-8088 - Phone
- (262) 880-4664
- Fax
- (262) 447-0850
- NPI assigned
- Jun 29, 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 Therapist | 225X00000X | 7009-26 | WI | Primary |
Addresses
Primary practice location
1604 Legend Hill LN
Waukesha, WI 53189-8088
Mailing address
1604 Legend Hill LN
Waukesha, WI 53189-8088
Phone (262) 880-4664
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1548830995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1604 LEGEND HILL LN",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531898088",
"telephone_number": "262-880-4664",
"fax_number": "262-447-0850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 LEGEND HILL LN",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531898088",
"telephone_number": "262-880-4664",
"fax_number": "262-447-0850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTO",
"first_name": "SHELBY",
"middle_name": "LYNN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "7009-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.