Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shelley Ullom

Individual provider Occupational Therapist · NPI 1619094737

Shelley Ullom is an Occupational Therapist in Private Practice in Indianapolis, Indiana. Graduated from Ohio State University - College of Optometry in 2004, 22 years ago. Practices with Clarkson Optometry Midwest Inc, a 76-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
22
Trained at
Ohio State University - College of Optometry
Licensed in
IN
In the registry since
2007
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Practice location Address checks out

4740 Kingsway Dr
Indianapolis, IN 46205-1521
Phone: (317) 466-1000
Fax: (317) 466-2000
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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 31004195A (IN)

Record details

NPI number1619094737
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 23, 2007
Last updated in NPPESDecember 30, 2019
Certification dateDecember 30, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Graduated 2004 (22 years in practice)
Group practice Clarkson Optometry Midwest Inc — 76 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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