Individual provider Active NPI

Jasmine Shah, OTR/L

  • Occupational Therapist
  • Cary, NC
National Provider Identifier
1902441744
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12918 Issued in NC
Practice address
303 Page Square Dr
Cary, NC 27513-6200
Phone
(919) 539-8920
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 12918 NC Primary

Addresses

Primary practice location

303 Page Square Dr
Cary, NC 27513-6200

Mailing address

303 Page Square Dr
Cary, NC 27513-6200
Phone (919) 539-8920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241101000440 NC Practitioner - Occupational Therapist in Private Practice 4284167099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nancy M Mackowsky OD PAGroup PAC ID 7315074523, 2 clinicians

Practice addresses (Care Compare)

4505 Fair Meadows LN
Suite 207
Raleigh, NC 27607-6449
Phone (919) 787-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12918NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy M. Mackowsky, OD, PA Single Specialty CurrentSince Oct 8, 2024 Accepting new patients

Locations

4505 Fair Meadows Ln
Ste 207
Raleigh, NC 27607
Phone (919) 787-7600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1902441744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PAGE SQUARE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275136200",
            "telephone_number": "919-539-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PAGE SQUARE DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275136200",
            "telephone_number": "919-539-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JASMINE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "12918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.