Shannon Marie Williams, OTR/L, CLT

Primary specialty

Environmental Modification Occupational TherapistTaxonomy code 225XE0001X

License

10328 Issued in NC

Practice address

607 Wagon Rd
Morehead City, NC 28557-3174

Phone

(443) 789-8530

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crystal Coast Wellness and Performance CenterGroup PAC ID 8527489913, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Crystal Coast Wellness and Performance Center

  • Registered Dietitian
  • Morehead City, NC
  • NPI 1679104293
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1568189397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WAGON RD",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573174",
            "telephone_number": "443-789-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WAGON RD",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573174",
            "telephone_number": "443-789-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "10328",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "NC",
            "license": "10328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William S. Harvey III Dds10 PLLC
• William S. Harvey, III DDS2
• Amanda Williams
• Carly Flora Williams, MS CCC-SLP
• Robert Miller Williams Jr., R.PH.
• Liberty Kyle Willis
• Jack Tyler Winchester, DMD
• Ashley Winkleman, PSY.D.
• Mary D. Withington, MT-BC
• Jill Witofsky

• Occupational Therapist in Morehead City, NC
• Providers in Morehead City, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.