Individual provider Active NPI

Shannon Levandowski, OT

  • Pediatric Occupational Therapist
  • Frisco, TX
National Provider Identifier
1679780175
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056006691 Issued in IL
Practice address
11508 Promenade Rd
Frisco, TX 75035-6333
Phone
(414) 698-8298
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 056006691 IL Primary
Pediatric Occupational Therapist 225XP0200X 4129026 WI

Addresses

Primary practice location

11508 Promenade Rd
Frisco, TX 75035-6333

Mailing address

11508 Promenade Rd
Frisco, TX 75035-6333

Other practice location 1

10401 Grand Ave
Franklin Park, IL 60131-2208
Phone (847) 455-5299

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
056006691ILMDPediatric Occupational Therapist
4129026WIMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679780175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11508 PROMENADE RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750356333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11508 PROMENADE RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750356333",
            "telephone_number": "414-698-8298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10401 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Franklin Park",
            "state": "IL",
            "postal_code": "601312208",
            "country_code": "US",
            "telephone_number": "847-455-5299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVANDOWSKI",
        "first_name": "SHANNON",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056006691",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WI",
            "license": "4129026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.