Mary Beth Shepardson, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

006224-1 Issued in NY

Practice address

7 Timmerman Ave
St Johnsville, NY 13452-1017

Phone

(518) 568-5037

Fax

(518) 568-5477

NPI assigned

Nov 13, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Rehab PT OT PLLCGroup PAC ID 5395244685, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nova Rehab PT OT PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1801782750

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790856532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VALLEY BROOK DR",
            "city": "LITTLE FALLS",
            "state": "NY",
            "postal_code": "133651126",
            "telephone_number": "315-823-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 TIMMERMAN AVE",
            "city": "ST JOHNSVILLE",
            "state": "NY",
            "postal_code": "134521017",
            "telephone_number": "518-568-5037",
            "fax_number": "518-568-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARDSON",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "006224-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01131093",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig L. Murcray, O.D.
• Oppenheim-Ephratah Central School
• Oppenheim-Ephratah-St.Johnsville CSD
• Performance Therapy and Fitness, LLC
• Shruti Sharma
• Ina F Smith, LCSW-R
• Susan Anne Smith, RN
• Ranbir S Sodhi, M.D.
• St. Johnsville Area Volunteer Ambulance Corp
• St. Johnsville Central School

• Occupational Therapist in St Johnsville, NY
• Providers in St Johnsville, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.