Active NPI
Shawn Buxton Wedderburn
- Occupational Therapist
- East Providence, RI
National Provider Identifier
1760294763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT02283
- Practice address
- 500 Waterfront Dr
East Providence, RI 02914-5048 - Phone
- (401) 272-5280
- NPI assigned
- Jan 25, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT02283 | RI | Primary |
Addresses
Primary practice location
500 Waterfront Dr
East Providence, RI 02914-5048
Mailing address
75 S Union St Unit 303
Pawtucket, RI 02860-3981
Phone (347) 327-0306
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT02283 | RI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737763200000",
"number": "1760294763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 S UNION ST UNIT 303",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028603981",
"telephone_number": "347-327-0306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 WATERFRONT DR",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "029145048",
"telephone_number": "401-272-5280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDDERBURN",
"first_name": "SHAWN",
"middle_name": "BUXTON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-25",
"last_updated": "2025-01-25",
"certification_date": "2025-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "RI",
"license": "OT02283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.