Shelby Raylynn Wilson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT012092 Issued in OH

Practice address

9320 Avalon Cir
Centerville, OH 45458-4989

Phone

(937) 885-5426

NPI assigned

Feb 14, 2023

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

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  OH, Single Specialty

  Medicare reassignment Care Compare group NPD
• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1548967110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 AVALON CIR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454584989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 AVALON CIR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454584989",
            "telephone_number": "937-885-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHELBY",
        "middle_name": "RAYLYNN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT012092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Willis
• Julie Kaye Wilson Ellis, LPN
• Chey-Anne L Wilson, IMFT
• Marcia Wilson
• Mary Judith Wilson, LPCC
• Elin Winninge-Oakes, RBT
• Joy L Witwer, LISW-SUPV
• Kevin Andrew Wolf, PT, DPT
• Christin Taylor Wolfram, NP
• Amy Noel Wooton, M.D.

• Occupational Therapist in Centerville, OH
• Providers in Centerville, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.