Active NPI
Shara Lee M Main, OT
- Occupational Therapist
- San Francisco, CA
National Provider Identifier
1962686618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- PENDING
- Practice address
- 4150 Clement St
Attn: Occupational Therapy GB-27
San Francisco, CA 94121-1545 - Phone
- (415) 221-4810
- NPI assigned
- Dec 18, 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 | PENDING | MT | Primary |
Addresses
Primary practice location
4150 Clement St
Attn: Occupational Therapy GB-27
San Francisco, CA 94121-1545
Mailing address
4150 Clement St
Attn: Occupational Therapy GB -27
San Francisco, CA 94121-1545
Phone (415) 221-4810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000663190 | Other | MT | BCBS PIN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1026 | MT | MD | Clinical Social Worker |
| PENDING | MT | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436918400000",
"number": "1962686618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST",
"address_2": "ATTN: OCCUPATIONAL THERAPY GB -27",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "415-221-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST",
"address_2": "ATTN: OCCUPATIONAL THERAPY GB-27",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "415-221-4810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIN",
"first_name": "SHARA LEE",
"middle_name": "M",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-18",
"last_updated": "2015-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MT",
"license": "PENDING",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "000663190",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.