Active NPI
Shannon Tambolleo, BS OT
- Occupational Therapist
- North Chatham, MA
National Provider Identifier
1962556845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7524
- Practice address
- 390 Orleans Rd
North Chatham, MA 02650-1154 - Phone
- (508) 945-9611
- Fax
- (508) 945-9603
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 7524 | MA | Primary |
Addresses
Primary practice location
390 Orleans Rd
North Chatham, MA 02650-1154
Mailing address
5 Federal LN
East Harwich, MA 02645-1348
Phone (774) 209-9187
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7524 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962556845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 FEDERAL LN",
"city": "EAST HARWICH",
"state": "MA",
"postal_code": "026451348",
"telephone_number": "774-209-9187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 ORLEANS RD",
"city": "NORTH CHATHAM",
"state": "MA",
"postal_code": "026501154",
"telephone_number": "508-945-9611",
"fax_number": "508-945-9603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMBOLLEO",
"first_name": "SHANNON",
"credential": "BS OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "7524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chatham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.