Individual provider Active NPI

Shelby Gray Behnke, OTD

  • Occupational Therapist
  • Fayetteville, NC
National Provider Identifier
1891442026
Registry record updated Jan 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
14728 Issued in NC
Practice address
1991 Fordham Dr Ste 102
Fayetteville, NC 28304-3774
Phone
(910) 484-4653
Fax
(910) 483-9256
NPI assigned
Mar 8, 2022
Last updated
Jan 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2024

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 14728 NC Primary

Addresses

Primary practice location

1991 Fordham Dr Ste 102
Fayetteville, NC 28304-3774

Mailing address

1991 Fordham Dr Ste 102
Fayetteville, NC 28304-3774
Phone (910) 484-4653

Other practice location 1

4140 Ferncreek Dr Ste 801
Fayetteville, NC 28314-2572
Phone (910) 484-2171

Other names 1

  • Shelby Anne Gray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220321001604 NC Practitioner - Occupational Therapist in Private Practice 8123413655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4140 Ferncreek Dr
Suite 801
Fayetteville, NC 28314-2572
Phone (910) 484-2171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14728NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Valley Health Medical Group LLC Occupational Therapist CurrentSince Oct 28, 2024 Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Oct 28, 2024 Accepting new patients

Locations

1991 Fordham Dr
Ste 102
Fayetteville, NC 28304
Phone (910) 484-4653

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

Interoperability endpoints

  • Direct secure messaging: shelby.behnkeotd.p1@direct.capefearortho.nextgenshare.com

Organizations & group practices 3

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": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1891442026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 FORDHAM DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043774",
            "telephone_number": "910-484-4653",
            "fax_number": "910-483-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 FORDHAM DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043774",
            "telephone_number": "910-484-4653",
            "fax_number": "910-483-9256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4140 Ferncreek Dr Ste 801",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283142572",
            "country_code": "US",
            "telephone_number": "910-484-2171",
            "fax_number": "910-484-4568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEHNKE",
        "first_name": "SHELBY",
        "middle_name": "GRAY",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "GRAY",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.