Active NPI
Shelly Lynn Coffin, OTR/L, CLT
- Occupational Therapist
- Gloversville, NY
National Provider Identifier
1851931950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 011587-1
- Practice address
- 99 E State St
Gloversville, NY 12078-1203 - Phone
- (518) 773-5541
- Fax
- (518) 773-5679
- NPI assigned
- Jan 7, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 011587-1 | NY | Primary |
Addresses
Primary practice location
99 E State St
Gloversville, NY 12078-1203
Mailing address
750 S Shore Rd
Northville, NY 12134-5929
Phone (518) 848-4537
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 |
|---|---|---|---|
| 011587-1 | NY | MD | Cardiopulmonary Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578355200000",
"number": "1851931950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 S SHORE RD",
"city": "NORTHVILLE",
"state": "NY",
"postal_code": "121345929",
"telephone_number": "518-848-4537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 E STATE ST",
"city": "GLOVERSVILLE",
"state": "NY",
"postal_code": "120781203",
"telephone_number": "518-773-5541",
"fax_number": "518-773-5679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFIN",
"first_name": "SHELLY",
"middle_name": "LYNN",
"credential": "OTR/L, CLT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-07",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "011587-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloversville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.