Active NPI
Tony Shaikoski
- Occupational Therapist
- Marshall, MN
National Provider Identifier
1639419021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104418
- Practice address
- 1420 E College Dr
Suite 704
Marshall, MN 56258-2065 - Phone
- (507) 532-3393
- Fax
- (320) 839-4196
- NPI assigned
- Feb 21, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 104418 | MN | Primary |
Addresses
Primary practice location
1420 E College Dr
Suite 704
Marshall, MN 56258-2065
Mailing address
309 Washington Ave
Ortonville, MN 56278-1357
Phone (320) 839-4271
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104418 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1639419021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 WASHINGTON AVE",
"city": "ORTONVILLE",
"state": "MN",
"postal_code": "562781357",
"telephone_number": "320-839-4271",
"fax_number": "320-839-4196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 E COLLEGE DR",
"address_2": "SUITE 704",
"city": "MARSHALL",
"state": "MN",
"postal_code": "562582065",
"telephone_number": "507-532-3393",
"fax_number": "320-839-4196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAIKOSKI",
"first_name": "TONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-21",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.