Individual provider Active NPI

Sherise Hextall, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1710587266
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
535 Flushing Ave
Brooklyn, NY 11205-1610
Phone
(929) 800-2340
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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 Primary

Addresses

Primary practice location

535 Flushing Ave
Brooklyn, NY 11205-1610

Mailing address

13560 232ND St
Laurelton, NY 11413-2536
Phone (929) 245-8588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017002602 GA Practitioner - Occupational Therapist in Private Practice 7416350715 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Oct 2, 2023 Accepting new patients
Fox Rehabilitation Ga, LLC Occupational Therapist CurrentSince Apr 1, 2024 Accepting new patients

Locations

3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1710587266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13560 232ND ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132536",
            "telephone_number": "929-245-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 FLUSHING AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051610",
            "telephone_number": "929-800-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEXTALL",
        "first_name": "SHERISE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.