Organization Active NPI

Kindred Spirits Occupational Therapy PLLC

  • Occupational Therapist
  • Flushing, NY
National Provider Identifier
1982004495
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
63017967 Issued in NY
Legal business name
KINDRED SPIRITS OCCUPATIONAL THERAPY PLLC
Practice address
4160 Main St Ste 209B
Flushing, NY 11355-3899
Phone
(917) 933-8503
Fax
(917) 463-1056
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Authorized official

Name
Mr. Mun S Shieh, OTR
Title
Occupational Therapy
Phone
(917) 362-2018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X 63017967 NY Primary

Addresses

Primary practice location

4160 Main St Ste 209B
Flushing, NY 11355-3899

Mailing address

69-14 183Rd Street Fresh Meadows
New York, NY 11365
Phone (917) 362-2018

Other practice location 1

2116 Ave.P
Brooklyn, NY 11229
Phone (718) 338-4850

Other names 1

  • Kindred Spirits OT PLLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1982004495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69-14 183RD STREET FRESH MEADOWS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11365",
            "telephone_number": "917-362-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 MAIN ST STE 209B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553899",
            "telephone_number": "917-933-8503",
            "fax_number": "917-463-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2116 AVE.P",
            "address_purpose": "LOCATION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "country_code": "US",
            "telephone_number": "718-338-4850",
            "fax_number": "718-338-7117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINDRED SPIRITS OCCUPATIONAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "SHIEH",
        "authorized_official_first_name": "MUN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPY",
        "authorized_official_telephone_number": "917-362-2018",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "63017967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Spirits OT PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.