MEDICARE: SHERI BURELL NISHIMURA OT, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT013598	GA
2	225X00000X	Occupational Therapist	2346	AL

General Provider Information

NPI Number	:	1467683409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERI BURELL NISHIMURA OT, LMT

Provider Business Mailing Address
First Line	:	2415 CANTER DR
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-7477
Country	:	US
Telephone Number	:	706-992-5868
Fax Number	:

Provider Business Practice Location Address
First Line	:	2357 WARM SPRINGS RD STE 120
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-5690
Country	:	US
Telephone Number	:	706-325-2583
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	04/10/2026

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