Shannon Jones, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2422 Issued in ID

Practice address

75 Lilac St
Blackfoot, ID 83221-1768

Phone

(208) 785-9917

NPI assigned

Aug 24, 2021

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1811664261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LILAC ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211768",
            "telephone_number": "208-785-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 LILAC ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211768",
            "telephone_number": "208-785-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHANNON",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ID",
            "license": "2422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lafayette Johnson, D.C.
• Pete Richar Johnson
• Scott C. Johnson, PHARMD,
• Cody E Jones, O.D.
• Larry Christian Jones, LMSW
• Anita Kadikar, MD
• James Taylor Kelley, PHARMD
• Michele Kelly, LCSW
• Mark A Kennington, DC
• Ryan Blair Killpack, PA-C

• Occupational Therapy Assistant in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Occupational Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.