Individual provider Active NPI

Shannon Grace Kenna, OTR/L

  • Occupational Therapist
  • Apex, NC
National Provider Identifier
1891422168
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17605 Issued in NC
Practice address
501 W Williams St Unit 346
Apex, NC 27502-1998
Phone
(919) 448-6018
Fax
(855) 264-2501
NPI assigned
Aug 5, 2022
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 17605 NC Primary

Addresses

Primary practice location

501 W Williams St Unit 346
Apex, NC 27502-1998

Mailing address

905 Odyssey Dr
Durham, NC 27713-1381
Phone (607) 725-8288

Other practice location 1

8282 Willett Pkwy
Baldwinsville, NY 13027-1306
Phone (315) 857-0800

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.oswegohealth.org/services/skilled-nursing/

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
17605NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All About Therapy, PLLC Occupational Therapist CurrentSince Jun 15, 2025 Accepting new patients

Locations

501 W Williams St
Unit 346
Apex, NC 27502
Phone (919) 448-6018

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1891422168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 ODYSSEY DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277131381",
            "telephone_number": "607-725-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W WILLIAMS ST UNIT 346",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275021998",
            "telephone_number": "919-448-6018",
            "fax_number": "855-264-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8282 Willett Pkwy",
            "address_purpose": "LOCATION",
            "city": "Baldwinsville",
            "state": "NY",
            "postal_code": "130271306",
            "country_code": "US",
            "telephone_number": "315-857-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNA",
        "first_name": "SHANNON",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "17605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.oswegohealth.org/services/skilled-nursing/",
            "affiliation": "N",
            "address_1": "20 Manor Dr",
            "city": "Oswego",
            "state": "NY",
            "country_code": "US",
            "postal_code": "131266495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.