Individual provider Active NPI

Elyse Shivers, MS, OTR/L

  • Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1811379670
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
005542 Issued in GA
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone
(404) 922-8328
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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 005542 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1059

Mailing address

1364 Clifton Rd NE
Atlanta, GA 30322-1059

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
005542GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1811379670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-922-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVERS",
        "first_name": "ELYSE",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "005542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.