Active NPI
Shelby Bryant
- Occupational Therapist
- Pueblo, CO
National Provider Identifier
1629444096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- BOTDCT00221513
- Practice address
- 1301 Fortino Blvd
Pueblo, CO 81008 - Phone
- (719) 696-7799
- NPI assigned
- Aug 19, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | BOTDCT00221513 | KY | Primary |
Addresses
Primary practice location
1301 Fortino Blvd
Pueblo, CO 81008
Mailing address
2233 Academy PL Ste 200
Colorado Springs, CO 80909-1666
Other practice location 1
3117 Alvey Park Dr W
Owensboro, KY 42303-2139
Phone (270) 683-9992
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 |
|---|---|---|---|
| BOTDCT00221513 | KY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JB Therapy Services PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Owensboro, KY
- NPI 1710200399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1629444096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2233 ACADEMY PL STE 200",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809091666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 FORTINO BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "81008",
"telephone_number": "719-696-7799"
}
],
"practiceLocations": [
{
"address_1": "3117 Alvey Park Dr W",
"address_purpose": "LOCATION",
"city": "Owensboro",
"state": "KY",
"postal_code": "423032139",
"country_code": "US",
"telephone_number": "270-683-9992",
"fax_number": "270-683-9993",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRYANT",
"first_name": "SHELBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-19",
"last_updated": "2024-02-20",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "BOTDCT00221513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.