Active NPI
Shelly Lynn Shipley, COTA
- Occupational Therapy Assistant
- Eau Claire, WI
National Provider Identifier
1558424101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1840-027
- Practice address
- 1405 Truax Blvd
Eau Claire, WI 54703-1474 - Phone
- (715) 552-1030
- NPI assigned
- Dec 18, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1840-027 | WI | Primary |
Addresses
Primary practice location
1405 Truax Blvd
Eau Claire, WI 54703-1474
Mailing address
1405 Truax Blvd
Eau Claire, WI 54703-1474
Phone (715) 552-1030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40903900 | Medicaid | WI |
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 |
|---|---|---|---|
| 1840-027 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1558424101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 TRUAX BLVD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547031474",
"telephone_number": "715-552-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 TRUAX BLVD",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547031474",
"telephone_number": "715-552-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPLEY",
"first_name": "SHELLY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "1840-027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40903900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
- Donna J. Shimoda, LCSW
- Jon S Shimoda, DC
- Minakshi R Shinde, M.D.
- Larry Shingleton, PT
- Patrick A Shinners, MD
- Shook Family Dental LLC
- Randal E. Shook, DDS
- Shopko Institutional Care Services Co LLC (Shopko RxCare)
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 024)
- Shopko Stores Operating Co. LLC (ShopKo Optical 024)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.