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

Individual provider Occupational Therapist · NPI 1548610041

Shane Johnson, OTR/L is an Occupational Therapist in Surprise, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2016
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

18480 W Port Royale Ln
Surprise, AZ 85388-7678
Phone: (623) 776-5626
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 2743 (AZ)

Record details

NPI number1548610041
Entity typeIndividual (Type 1)
GenderMale
Credentials OTR/L
Sole proprietorYes
NPI enumeratedJune 15, 2016
Last updated in NPPESJune 15, 2016
Mailing address18480 W Port Royale Ln, Surprise, AZ 85388-7678

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