Shannon Elizabeth Funk, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201010569 Issued in MI

Practice address

575 N Madison St
Marshall, MI 49068-1148

Phone

(269) 781-4281

NPI assigned

May 24, 2019

Last updated

May 24, 2019By the provider in NPPES

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)

Enrolled

State licenses

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1881251825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5370 E C AVE",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "490839514",
            "telephone_number": "630-750-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N MADISON ST",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681148",
            "telephone_number": "269-781-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Louise Flores-Valle, NA
• Megan Floyd, C.N.M.
• Sherry L Flynn, RN
• Rhea Diane Freitag, MA, LPC
• Marcia Lynn French, FNP-C
• Christopher Moore Gaffga, M.D.
• Peter Anthony Galea II, CRNA
• Emily Gallagher, D.D.S.
• Melissa Kay Gates, D.O.
• Ronald A Gauthier, CRNA

• Occupational Therapist in Marshall, MI
• Providers in Marshall, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.