Active NPI
Kevin Shaw, OT
- Occupational Therapist
- St Petersburg, FL
National Provider Identifier
1881865202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT10326
- Practice address
- 3101 37TH Ave N
Suite a
St Petersburg, FL 33713-1509 - Phone
- (727) 328-0599
- NPI assigned
- Mar 13, 2008
- Sex
- Male
- 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 | OT10326 | FL | Primary |
Addresses
Primary practice location
3101 37TH Ave N
Suite a
St Petersburg, FL 33713-1509
Mailing address
4207 S Dale Mabry Hwy
#1109
Tampa, FL 33611-1423
Phone (727) 776-4181
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 |
|---|---|---|---|
| OT10326 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1881865202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4207 S DALE MABRY HWY",
"address_2": "#1109",
"city": "TAMPA",
"state": "FL",
"postal_code": "336111423",
"telephone_number": "727-776-4181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 37TH AVE N",
"address_2": "SUITE A",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337131509",
"telephone_number": "727-328-0599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "KEVIN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-13",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT10326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.