Active NPI
Theresa Lynn Shaffer-Wethington, OTR
- Occupational Therapist
- Greeley, CO
National Provider Identifier
1801940390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 2117 40TH Ave
Greeley, CO 80634-3901 - Phone
- (970) 302-3980
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 0023819 | CO | |
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
2117 40TH Ave
Greeley, CO 80634-3901
Mailing address
2117 40TH Ave
Greeley, CO 80634-3901
Phone (970) 302-3980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69107084 | Medicaid | CO |
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 |
|---|---|---|---|
| 0023819 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1801940390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2117 40TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806343901",
"telephone_number": "970-302-3980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2117 40TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806343901",
"telephone_number": "970-302-3980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER-WETHINGTON",
"first_name": "THERESA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2020-11-20",
"certification_date": "2020-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "CO",
"license": "0023819",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "69107084",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.