Kerry Shidel, OT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-003737 Issued in OH

Practice address

5000 Rockside Rd Ste 400
Independence, OH 44131-6826

Phone

(216) 642-6044

NPI assigned

Jun 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1891990891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10325 WANDA CIR NE",
            "city": "HARTVILLE",
            "state": "OH",
            "postal_code": "446329776",
            "telephone_number": "330-936-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 ROCKSIDE RD STE 400",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441316826",
            "telephone_number": "216-642-6044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7233 Whipple Ave NW",
            "address_purpose": "LOCATION",
            "city": "North Canton",
            "state": "OH",
            "postal_code": "447207137",
            "country_code": "US",
            "telephone_number": "330-498-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIDEL",
        "first_name": "KERRY",
        "name_prefix": "Mr.",
        "credential": "OT/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT-003737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Independence, OH
• Providers in Independence, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.