Shannon McIntosh

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4787 Issued in MS

Practice address

9 Balmoral Dr Ste a
Poplarville, MS 39470-3344

Phone

(601) 746-5101

Fax

(601) 746-5102

NPI assigned

Jul 19, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Mississippi School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bright Steps Therapy, LLCGroup PAC ID 6709276090, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bright Steps Therapy LLC

  • Physical Therapist
  • Poplarville, MS
  • NPI 1245857978
  Medicare reassignment Care Compare group NPD
• The Summit Health & Rehab Services, Inc

  • Physical Therapist
  • McComb, MS
  • NPI 1962477943
  NPD (past)
• Bright Steps Therapy LLC

  • Physical Therapist
  • Bogalusa, LA
  • NPI 1720931652
  NPD (past)
• The Summit Health & Rehab Services, Inc

  • Physical Therapy Clinic/Center
  • Pell City, AL
  • NPI 1235428277
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1003104415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BALMORAL DR STE A",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394703344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BALMORAL DR STE A",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394703344",
            "telephone_number": "601-746-5101",
            "fax_number": "601-746-5102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 N Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393079020",
            "country_code": "US",
            "telephone_number": "601-693-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Lott, PHARM D
• Sarah M Lowery, SLP
• Andrea Gail Mannarino, COTA
• Brittney F Marshall, MS, CCC-SLP
• Marquita Le'Ann McIntosh, OTD, OTR/L
• Aloha Rodriguez Moll
• Mishako M Moore, OT
• Terry Anthony Moran Jr., DO
• Kaci L Morris, DPT
• Kelly M Mullen, REGISTERED NURSE

• Physical Therapist in Poplarville, MS
• Providers in Poplarville, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.