Shannon Rebecca Gaetke, OTD, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

4091 Issued in SC

Practice address

120 Springhall Dr
Goose Creek, SC 29445-5335

Phone

(843) 216-0290

Fax

(843) 216-2445

NPI assigned

Mar 28, 2013

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Coastal Therapy Services, Inc.

  • Speech-Language Pathologist
  • Mt Pleasant, SC
  • NPI 1285641308
  NPD (past)
• Coastal Therapy Services, Inc.

  • Speech-Language Pathologist
  • Goose Creek, SC
  • NPI 1710330683
  NPD (past)

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1629311618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1753",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294651753",
            "telephone_number": "843-216-0290",
            "fax_number": "843-216-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SPRINGHALL DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455335",
            "telephone_number": "843-216-0290",
            "fax_number": "843-216-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETKE",
        "first_name": "SHANNON",
        "middle_name": "REBECCA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "4091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Friendly Hands Nursing Agency
• Candace Genevieve Fritz, OTR/L
• Caitlyn Fry, PHARMD
• Lane Funke, ORT/L
• Sharon M Gadsden
• Justin E Gallagher, MD
• Gamble Dentalsmart PC
• Cristina Gambrell
• Amanda Ho Van Garrett, DMD
• Mark Richard Garvey, PHARMD

• Pediatric Occupational Therapist in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Pediatric Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.