Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Shane Burgess, COTA/L

Individual provider Skilled Nursing Facility · NPI 1932363736

Mr. Shane Burgess, COTA/L is a Skilled Nursing Facility in Paris, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2008
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

310 S Eads Ave
Paris, IL 61944-1938
Phone: (217) 465-5395
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 057.002001 (IL)

Record details

NPI number1932363736
Entity typeIndividual (Type 1)
GenderMale
Credentials COTA/L
Sole proprietorYes
NPI enumeratedJuly 11, 2008
Last updated in NPPESJuly 11, 2008

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