Bethany Dawn Shannon, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

209824 Issued in TX

Practice address

4343 Oak Grove Blvd.
San Angelo, TX 76904

Phone

(325) 942-4000

NPI assigned

Aug 3, 2015

Last updated

Aug 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Bethany Rodden Former name

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1932585809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 HIGH TECH AVE.",
            "address_2": "STE. 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32817",
            "telephone_number": "800-774-7785",
            "fax_number": "877-217-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 OAK GROVE BLVD.",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76904",
            "telephone_number": "325-942-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "BETHANY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "209824",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "3267",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "RODDEN",
            "prefix": "MRS.",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shannon Primary Care Clinic
• Shannon Rehabilitation Hospital, LLC (Shannon Rehabilitation Hospital, an affiliate of Encompass Health)
• Shannon Rural Health Clinics, Inc (Senior Clinic)
• Shannon Senior Health Clinic
• Shannon Specialty Care Clinic
• Michele Sharon, L.P.C.
• Gayle Sharpsteen, APRN, FNP-C
• Evelyn Shaw, MA
• Mary Ann Shaw, RBT
• Eddie G Shell II, MD

• Occupational Therapy Assistant in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.