Active NPI
Shawn Wolfe
- Occupational Therapist
- Roland, OK
National Provider Identifier
1609079623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 736
- Practice address
- 300 Ranger Blvd
Roland, OK 74954-4040 - Phone
- (479) 430-0497
- NPI assigned
- Jun 7, 2007
- Last updated
- Nov 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR511 | AR | |
| Occupational Therapist | 225X00000X | 736 | OK | Primary |
Addresses
Primary practice location
300 Ranger Blvd
Roland, OK 74954-4040
Mailing address
1635 Kings Way
Alma, AR 72921-5144
Phone (479) 430-0497
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 |
|---|---|---|---|
| OTR511 | AR | MD | Occupational Therapist |
| 736 | OK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1609079623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 KINGS WAY",
"city": "ALMA",
"state": "AR",
"postal_code": "729215144",
"telephone_number": "479-430-0497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 RANGER BLVD",
"city": "ROLAND",
"state": "OK",
"postal_code": "749544040",
"telephone_number": "479-430-0497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFE",
"first_name": "SHAWN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-07",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR511",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OK",
"license": "736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roland, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.