Individual provider Active NPI

Shannon Coyle Riordan, O.T.

  • Occupational Therapist
  • Mandeville, LA
National Provider Identifier
1811152820
Registry record updated Jul 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTT.Z11085 Issued in LA
Practice address
157 Grand Maison Blvd
Mandeville, LA 70471-8508
Phone
(985) 626-7449
Fax
(985) 626-7449
NPI assigned
Jul 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTT.Z11085 LA Primary

Addresses

Primary practice location

157 Grand Maison Blvd
Mandeville, LA 70471-8508

Mailing address

157 Grand Maison Blvd
Mandeville, LA 70471-8508
Phone (985) 626-7449

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

LicenseStateTypeSpecialty
OTT.Z11085LAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216512000000",
    "number": "1811152820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 GRAND MAISON BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704718508",
            "telephone_number": "985-626-7449",
            "fax_number": "985-626-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 GRAND MAISON BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704718508",
            "telephone_number": "985-626-7449",
            "fax_number": "985-626-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIORDAN",
        "first_name": "SHANNON",
        "middle_name": "COYLE",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-20",
        "last_updated": "2008-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "OTT.Z11085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2008; 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.