Nichole Renee Shadle, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OP002604L Issued in PA

Practice address

2140 Warrensville Rd
Montoursville, PA 17754-9621

Phone

(570) 433-3161

NPI assigned

Dec 28, 2017

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": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1801302864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HIDDEN OAKS DR",
            "city": "JERSEY SHORE",
            "state": "PA",
            "postal_code": "177407108",
            "telephone_number": "570-753-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 WARRENSVILLE RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177549621",
            "telephone_number": "570-433-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADLE",
        "first_name": "NICHOLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP002604L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Ross
• Letitia Saylor, CRNA
• Lisa C. Schaeffer, PT
• William George Schlachter, R.PH., FASCP, CGP
• Marc William Schoch
• Shruti Atul Shah, DDS
• Tamoor Shahid, MD
• Jill A Sharer, M.D.
• Kassy S Shenberger
• Vicki Yandell Shimko, PT

• Occupational Therapy Assistant in Montoursville, PA
• Providers in Montoursville, PA by specialty
• Occupational Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.