Healthcare Provider Details

I. General information

NPI: 1952566226
Provider Name (Legal Business Name): SHANNON KALMER FERGUSON OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON MICHELLE KALMER OTR/L, CHT

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 BARRINGTON CIR
FAYETTEVILLE NC
28303-4284
US

IV. Provider business mailing address

608 MCGRUDER ST NE
ATLANTA GA
30312-1604
US

V. Phone/Fax

Practice location:
  • Phone: 910-892-0027
  • Fax:
Mailing address:
  • Phone: 773-848-0354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6926
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT005008
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: