Active NPI
Nicolette Shaffer, OTR
- Occupational Therapist
- Fort Myers, FL
National Provider Identifier
1922589050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 18654
- Practice address
- 15101 Shell Point Blvd
Fort Myers, FL 33908-1694 - Phone
- (239) 466-1131
- NPI assigned
- Aug 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 18654 | FL | Primary |
Addresses
Primary practice location
15101 Shell Point Blvd
Fort Myers, FL 33908-1694
Mailing address
2101 Lakeview Dr W
Royal Palm Beach, FL 33411-8777
Phone (561) 891-7463
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18654 | FL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535328000000",
"number": "1922589050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 LAKEVIEW DR W",
"city": "ROYAL PALM BEACH",
"state": "FL",
"postal_code": "334118777",
"telephone_number": "561-891-7463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15101 SHELL POINT BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339081694",
"telephone_number": "239-466-1131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "NICOLETTE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-27",
"last_updated": "2018-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "FL",
"license": "18654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
- SFWC Medical Inc (southwest florida wellness center)
- Alicia Sgroi, PA-C
- Jan Rosalyn Shabot, LCSW
- Shady Rest Care Pavilion, Inc. (Page Rehabilitation and Healthcare Center)
- Amber Dawn Shaffer, DNP
- Bhavan Upendrakumar Shah, M.D.
- Bipin Shah, M.D.
- Jay Chetan Shah, DMD
- Pranav Shah, M.D
- Roshani P Shah, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.