Individual provider Active NPI

Shannon Nicole Huffman, COTA/L

  • Occupational Therapy Assistant
  • Jacksonville, NC
National Provider Identifier
1861662488
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
6778 Issued in NC
Practice address
3861 Richlands Hwy
Jacksonville, NC 28540-7188
Phone
(910) 389-2510
NPI assigned
Mar 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 6778 NC Primary

Addresses

Primary practice location

3861 Richlands Hwy
Jacksonville, NC 28540-7188

Mailing address

3861 Richlands Hwy
Jacksonville, NC 28540-7188
Phone (910) 389-2510

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
6778NCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1861662488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3861 RICHLANDS HWY",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285407188",
            "telephone_number": "910-389-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3861 RICHLANDS HWY",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285407188",
            "telephone_number": "910-389-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "6778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.