Malissa A Shiley, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

46TA09054100 Issued in NJ

Practice address

73 Old Toms River Rd.
Brick, NJ 08723-2700

Phone

(732) 451-1000

Fax

(732) 451-0887

NPI assigned

Sep 14, 2007

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1780870535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 OLD TOMS RIVER RD.",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087232701",
            "telephone_number": "732-451-1000",
            "fax_number": "732-451-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 OLD TOMS RIVER RD.",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087232700",
            "telephone_number": "732-451-1000",
            "fax_number": "732-451-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILEY",
        "first_name": "MALISSA",
        "middle_name": "A",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NJ",
            "license": "46TA09054100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Brick, NJ
• Providers in Brick, NJ by specialty
• Occupational Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.