Individual provider Active NPI

Elizabeth Shamon, OTD, OTR/L

  • Occupational Therapist
  • Surprise, AZ
National Provider Identifier
1679313019
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-009606 Issued in AZ
Practice address
15116 N Cotton LN
Surprise, AZ 85388-9618
Phone
(800) 376-3440
NPI assigned
May 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH-009606 AZ Primary

Addresses

Primary practice location

15116 N Cotton LN
Surprise, AZ 85388-9618

Mailing address

15116 N Cotton LN
Surprise, AZ 85388-9618

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

LicenseStateTypeSpecialty
OTH-009606AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
T.E.a.M. 4 Kids, LLC CurrentSince Jun 2, 2024 Accepting new patients

Locations

15116 N Cotton Ln
Surprise, AZ 85388
Phone (623) 322-8250

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": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1679313019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15116 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15116 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889618",
            "telephone_number": "800-376-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMON",
        "first_name": "ELIZABETH",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.