Shannon Diane Christianson, DPT
Individual provider Active NPI Physical Therapy Clinic/Center · Long Beach, CA
NPI 1003001975 · NPPES record last updated Nov 28, 2011
Key facts
- NPI
- 1003001975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Practice address
- 3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013 - Phone
- (562) 986-2375
- NPI assigned
- Sep 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shellman Inc PA
Practice addresses (Care Compare)
1172 W Hayden Ave
Hayden, ID 83835-8700
Phone (208) 762-3332
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210419002613 | ID | Practitioner - Physical Therapist in Private Practice | 9638207293 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonny Physical Therapy, LLC | Current |
Accepting new patients | |
| Shellman Inc PA | Physical Therapy | Current |
Accepting new patients |
Locations
1917 N Lakewood Dr
Coeur D Alene, ID 83814
Phone (208) 664-8194
1172 W Hayden Ave
Hayden, ID 83835
Phone (208) 762-3332
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Mailing address
3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Other providers in Long Beach, CA
- Steven Donald Chretien
- Roger Anthony Christensen
- Susan Elizabeth Christensen
- Barbara Louise Christian
- Sade Lashaun Christian
- Christina Mishreki Chiropractic Corporation
- Christina Turner, O.D., Inc.
- Christine Truong, OD, Optometric Corporation
- Christopher Hoshino MD Inc
- Marla Vichenzia Christopher
All providers in Long Beach, CA · Physical Therapy Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.