Sandra Dianne Shively, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2015001725 Issued in MO

Practice address

1901 E Hamilton St
Kirksville, MO 63501-3904

Phone

(660) 626-1444

NPI assigned

Jan 26, 2024

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

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1669234522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 SHELBY 357",
            "city": "SHELBYVILLE",
            "state": "MO",
            "postal_code": "634692531",
            "telephone_number": "573-501-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013904",
            "telephone_number": "660-626-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "SANDRA",
        "middle_name": "DIANNE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-26",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2015001725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip James Shara, DO
• Pranav Sharma
• Ricki Sheldon, DO
• James Ronald Sherstoff
• Soha Sherwani
• Stacey Shores
• Michael David Showers
• Angella Dawn Shuey, WHNP
• Elisha Marie Shultz, LMSW
• Ali Hassan Siddiqui

• Occupational Therapy Assistant in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.