Individual provider Active NPI

Shannon Caldwell

  • Pediatric Occupational Therapist
  • Cincinnati, OH
National Provider Identifier
1649822693
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
3430 Burnet Ave # 4007
Cincinnati, OH 45229-2833
Phone
(513) 636-4200
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X Primary

Addresses

Primary practice location

3430 Burnet Ave # 4007
Cincinnati, OH 45229-2833

Mailing address

3430 Burnet Ave # 4007
Cincinnati, OH 45229-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812000319 CO Practitioner - Occupational Therapist in Private Practice 4486070265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain States Hand and Physical Therapy, Inc.Group PAC ID 4688687767, 12 clinicians

Practice addresses (Care Compare)

4045 Wadsworth Blvd
Suite 210
Wheat Ridge, CO 80033-4624
Phone (303) 953-3163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain States Hand and Physical Therapy, Inc. CurrentSince Nov 4, 2023 Accepting new patients

Locations

8020 Lee Dr
Arvada, CO 80005
Phone (303) 422-1755

400 S McCaslin Blvd
Ste 208
Superior, CO 80027
Phone (303) 422-1755

4045 Wadsworth Blvd
Ste 210
Wheat Ridge, CO 80033
Phone (303) 467-3490

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.

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1649822693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 BURNET AVE # 4007",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 BURNET AVE # 4007",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292833",
            "telephone_number": "513-636-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.