Active NPI
Nicholas Shahmohammadi
- Occupational Therapist
- Pueblo, CO
National Provider Identifier
1649093683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT.0009175
- Practice address
- 1301 Fortino Blvd
Pueblo, CO 81008-2032 - Phone
- (719) 696-7799
- NPI assigned
- Nov 7, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA.0014131 | CO | |
| Occupational Therapist | 225X00000X | OT.0009175 | CO | Primary |
Addresses
Primary practice location
1301 Fortino Blvd
Pueblo, CO 81008-2032
Mailing address
2233 Academy PL Ste 200
Colorado Springs, CO 80909-1666
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 |
|---|---|---|---|
| PTA.0014131 | CO | MD | Physical Therapy Assistant |
| OT.0009175 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766016000000",
"number": "1649093683",
"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": "810082032",
"telephone_number": "719-696-7799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHMOHAMMADI",
"first_name": "NICHOLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-07",
"last_updated": "2025-12-18",
"certification_date": "2025-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CO",
"license": "PTA.0014131",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "OT.0009175",
"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 Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.