Individual provider Active NPI

Shital U Shilotri

  • Physical Therapist
  • Lilburn, GA
National Provider Identifier
1013112648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008912 Issued in GA
Practice address
4562 Lawrenceville Hwy NW Ste 201
Lilburn, GA 30047-3650
Phone
(770) 806-4136
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008912 GA Primary

Addresses

Primary practice location

4562 Lawrenceville Hwy NW Ste 201
Lilburn, GA 30047-3650

Mailing address

1750 Shiloh Rd NW Apt 712
Kennesaw, GA 30144-6466

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

LicenseStateTypeSpecialty
PT008912GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013112648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 SHILOH RD NW APT 712",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4562 LAWRENCEVILLE HWY NW STE 201",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473650",
            "telephone_number": "770-806-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILOTRI",
        "first_name": "SHITAL",
        "middle_name": "U",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

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.

Verify at the official NPI Registry.