Shawn C Roll, PHD, OTR/L, RMSKS

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12323 Issued in CA

Practice address

1640 Marengo St Ste 412
Los Angeles, CA 90033-1036

Phone

(323) 442-3340

NPI assigned

Jun 7, 2021

Last updated

Oct 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Usc University Hospital, Inc.

  dba USC Hospital

  • Psychiatric Hospital Unit
  • Los Angeles, CA
  • NPI 1790718500
  NPD (past)
• Usc Verdugo Hills Hospital, LLC

  dba Verdugo Hills Hospital

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1265875207
  NPD (past)

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1881261048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MARENGO ST STE 412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331036",
            "telephone_number": "323-442-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "SHAWN",
        "middle_name": "C",
        "credential": "PHD, OTR/L, RMSKS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "5928",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Roldan
• Andrew Roletti
• William D. Rolfe
• Kendall Paige Rolie, MFT INTERN
• Luc P Rolin, MSW
• Tajhicia Rolle, MSW, MSCJ
• Raquel Roller
• Darren Rollerson, RPH
• Jordan Albert Rollerson
• Johnathon Curtis Rollo, MD

• Occupational Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.