Healthcare Provider Details

I. General information

NPI: 1447178306
Provider Name (Legal Business Name): SHELBY HEATH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELBY SIBERT

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E 32ND ST
JOPLIN MO
64804-4404
US

IV. Provider business mailing address

4500 E 32ND ST
JOPLIN MO
64804-4404
US

V. Phone/Fax

Practice location:
  • Phone: 417-530-5654
  • Fax:
Mailing address:
  • Phone: 417-530-5654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2024043501
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: