Shannon Marie Desilets, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2387 Issued in NH

Practice address

184 Mammoth Rd
Londonderry, NH 03053-3254

Phone

(603) 434-8300

Fax

(603) 965-1057

NPI assigned

Apr 25, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Softouch for Wellness, PLLC

  • Physical Therapist
  • Pembroke, NH
  • NPI 1295044238
  NPD (past) Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013136027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MEADOW LARK DR",
            "city": "PEMBROKE",
            "state": "NH",
            "postal_code": "032752918",
            "telephone_number": "603-210-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 MAMMOTH RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533254",
            "telephone_number": "603-434-8300",
            "fax_number": "603-965-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESILETS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "2387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "08Y003331NH03",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8933036",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carly Dell'Ova
• Alexandra Gatzoulis Demos, M.S., CCC-SLP
• Charles Demoss
• Derry Dermatology, PLLC
• Matthew T Desena, MD
• Mark Kenneth Detweiler, M.D.
• Gagan Dhaliwal, DMD
• Richard Joseph Dinapoli, ED.D.
• Kamren E Dion-Benitez, MS
• Donna M. Eyssi, LLC

• All providers in Londonderry, NH
• Physical Therapist in New Hampshire

• 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.