Shelby Haller, OTR, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

124107 Issued in TX

Practice address

800 Riverwood CT Ste 110
Conroe, TX 77304-2824

Phone

(936) 391-8266

NPI assigned

Oct 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelby Smith Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1952182974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23200 FOREST NORTH DR APT 807",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392097",
            "telephone_number": "281-608-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIVERWOOD CT STE 110",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042824",
            "telephone_number": "936-391-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "SHELBY",
        "credential": "OTR, OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2023-10-06",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "124107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amber Dawn Hall, LMSW
• Kimberly Hall, NP
• Gage Matthew Hallbauer, MD
• Gregg M Hallbauer, DO
• Sarah Elizabeth Hallbauer, MD
• Jenna Leigh Hallmark, FNP
• Nico Halter, PT
• Brandi Halverson, LPC
• Alison Ham
• Amethyst Hamanaka

• Occupational Therapist in Conroe, TX
• Providers in Conroe, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.