Active NPI
Shannon Leigh Ely, LPTA
- Physical Therapy Assistant
- Rock Hill, SC
National Provider Identifier
1013033745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1413
- Practice address
- 831 McDow Dr
Rock Hill, SC 29732-2415 - Phone
- (803) 326-3116
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1413 | SC | Primary |
| Physical Therapy Assistant | 225200000X | 1401 | NC |
Addresses
Primary practice location
831 McDow Dr
Rock Hill, SC 29732-2415
Mailing address
7200 Mapleridge Dr
Charlotte, NC 28210-6512
Phone (704) 777-9925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1401 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 1413 | SC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013033745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7200 MAPLERIDGE DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282106512",
"telephone_number": "704-777-9925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 MCDOW DR",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297322415",
"telephone_number": "803-326-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELY",
"first_name": "SHANNON",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "SC",
"license": "1413",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "1401",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.