Active NPI
Shanna N Pogue, OTR
- Occupational Therapist
- Evansville, IN
National Provider Identifier
1891771721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31003323A
- Practice address
- 7300 E Indiana St
Ste 102
Evansville, IN 47715-2794 - Phone
- (812) 476-0409
- Fax
- (812) 476-1016
- NPI assigned
- Dec 22, 2005
- Sex
- Female
- 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 | 31003323A | IN | Primary |
Addresses
Primary practice location
7300 E Indiana St
Ste 102
Evansville, IN 47715-2794
Mailing address
7300 E Indiana St
Ste 102
Evansville, IN 47715-2794
Phone (812) 476-0409
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000486134 | Other | IN | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31003323A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prorehab Inc | Occupational Therapist | Past | Accepting new patients |
| Tri-State Orthopaedic Surgeons, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Evansville, IN
- NPI 1073501003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206403200000",
"number": "1891771721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 E INDIANA ST",
"address_2": "STE 102",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477152794",
"telephone_number": "812-476-0409",
"fax_number": "812-476-1016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 E INDIANA ST",
"address_2": "STE 102",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477152794",
"telephone_number": "812-476-0409",
"fax_number": "812-476-1016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POGUE",
"first_name": "SHANNA",
"middle_name": "N",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-22",
"last_updated": "2008-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31003323A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000486134",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.