Shasta Vernon, OTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA005564 Issued in OH

Practice address

530 S Main St
Lima, OH 45804

Phone

(419) 841-2200

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shasta DO Former name

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1871900837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6361 WEDGEWOOD DR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "43560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "45804",
            "telephone_number": "419-841-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "SHASTA",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA.05564",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA005564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHASTA",
            "last_name": "DO",
            "credential": "OTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jamie L Verhoff, CNP
• Kristine A Verhoff, RN CDE
• Stacey Verhoff
• Nathan Travis Vermillion, CNP
• Jeffrey Vernon, LISW
• Laine Alexa Vicarel, PHARMD, RPH
• Kiana Lynn Vickery, LSW
• Victress Health and Wellness LLC
• Vision Center of Lima, LLC
• Vitae Health Medical Ohio LLC

• Occupational Therapy Assistant in Lima, OH
• Providers in Lima, OH by specialty
• Occupational Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.