Active NPI
Shannon Marie Goldsmith, OTR
- Occupational Therapist
- Gloucester, VA
National Provider Identifier
1972707073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119003932
- Practice address
- 6099 T C Walker Rd
Gloucester, VA 23061-4403 - Phone
- (804) 693-7880
- Fax
- (804) 693-5203
- NPI assigned
- Jun 13, 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 | 0119003932 | VA | Primary |
Addresses
Primary practice location
6099 T C Walker Rd
Gloucester, VA 23061-4403
Mailing address
PO Box 1800
4830 David Dr.
Gloucester, VA 23061-1800
Phone (804) 693-6303
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0119003932 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521763200000",
"number": "1972707073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1800",
"address_2": "4830 DAVID DR.",
"city": "GLOUCESTER",
"state": "VA",
"postal_code": "230611800",
"telephone_number": "804-693-6303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6099 T C WALKER RD",
"city": "GLOUCESTER",
"state": "VA",
"postal_code": "230614403",
"telephone_number": "804-693-7880",
"fax_number": "804-693-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSMITH",
"first_name": "SHANNON",
"middle_name": "MARIE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2018-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119003932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloucester, VA
- Gloucester Mathews Care Clinic
- Gloucester Ophthalmic Associates, Inc
- Gloucester Orthopaedic Clinic P C (York River Orthopaedics & Sports Medicine)
- Gloucester Pediatrics, PC
- Gloucester Volunteer Fire and Rescue Squad, Inc.
- Brandi Dalton Gomez, NP
- Gloria J. Gordy, GLORIA GORDY
- John Constantine Gretes, MD
- Katherine C. Haggerty, NP
- Ronald D Haggerty, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.