Individual provider Active NPI

Stephanie Shuman, COTA/L

  • Occupational Therapy Assistant
  • Gilbert, AZ
National Provider Identifier
1578242467
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA-047263 Issued in AZ
Practice address
1550 N Stonehenge Dr Ste 104
Gilbert, AZ 85233-1244
Phone
(480) 813-1897
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA-047263 AZ Primary

Addresses

Primary practice location

1550 N Stonehenge Dr Ste 104
Gilbert, AZ 85233-1244

Mailing address

341 E Christopher St
San Tan Valley, AZ 85140-5740
Phone (480) 352-9646

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

LicenseStateTypeSpecialty
OTA-047263AZMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1578242467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 E CHRISTOPHER ST",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851405740",
            "telephone_number": "480-352-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N STONEHENGE DR STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331244",
            "telephone_number": "480-813-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAN",
        "first_name": "STEPHANIE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "OTA-047263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.