Individual provider Active NPI

Sheryl Egan-Olaivar, OT

  • Occupational Therapist
  • Gulfport, MS
National Provider Identifier
1962697458
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT0806 Issued in MS
Practice address
15476 Dedeaux Rd Ste a
Gulfport, MS 39503-2637
Phone
(228) 215-0700
NPI assigned
Sep 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT0806 MS Primary

Addresses

Primary practice location

15476 Dedeaux Rd Ste a
Gulfport, MS 39503-2637

Mailing address

6300 E Lake Blvd Ste 301
Vancleave, MS 39565-6771
Phone (228) 230-2663

Other practice location 1

1105 39th Ave
Gulfport, MS 39501-2654
Phone (285) 754-6542

Other identifiers 1

IdentifierTypeStateIssuer
09015385MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250530000953 MS Practitioner - Occupational Therapist in Private Practice 0143739334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bienville Therapy, LLCGroup PAC ID 1254878325, 24 clinicians

Practice addresses (Care Compare)

15476 Dedeaux Rd
Suite a
Gulfport, MS 39503-2637
Phone (228) 215-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bienville Therapy, LLC Occupational Therapist CurrentSince Aug 23, 2025 Accepting new patients
Bienville Therapy, LLC Occupational Therapist CurrentSince Aug 23, 2025 Accepting new patients
Encore Rehabilitation, Inc. Occupational Therapist CurrentSince Jun 1, 2025 Accepting new patients
Encore Rehabilitation, Inc. Occupational Therapist CurrentSince Jun 1, 2025 Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

42465 Highway 195
Haleyville, AL 35565
Phone (205) 486-2753

1720A Medical Park Dr
Ste 210
Biloxi, MS 39532
Phone (228) 546-3266

15476 Dedeaux Rd
#A
Gulfport, MS 39503
Phone (228) 215-0700

1105 39th Ave
Gulfport, MS 39501
Phone (228) 575-4654

433 Main St
Leakesville, MS 39451
Phone (601) 394-4545

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

6300 E Lake Blvd
Ste 101
Vancleave, MS 39565
Phone (228) 215-2240

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1962697458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD STE 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656771",
            "telephone_number": "228-230-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15476 DEDEAUX RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032637",
            "telephone_number": "228-215-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 39th Ave",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395012654",
            "country_code": "US",
            "telephone_number": "285-754-6542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGAN-OLAIVAR",
        "first_name": "SHERYL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-08",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT0806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015385",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.