Individual provider Active NPI

Shelby B McCory, PT, DPT

  • Physical Therapist
  • Seymour, IN
National Provider Identifier
1013563881
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013475A Issued in IN
Practice address
1940 E Tipton St Ste C
Seymour, IN 47274-3566
Phone
(812) 271-0042
Fax
(812) 248-8002
NPI assigned
Aug 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 05013475A IN Primary

Addresses

Primary practice location

1940 E Tipton St Ste C
Seymour, IN 47274-3566

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Other names 1

  • Shelby B Walls Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826001946 IN Practitioner - Physical Therapist in Private Practice 1456689603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1940 E Tipton St
Suite C
Seymour, IN 47274-3566
Phone (812) 271-0042

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Oct 13, 2021 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2019 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Oct 13, 2021 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist PastSince Feb 14, 2021 Accepting new patients
Southern Indiana Orthopedics Inc PastSince Sep 1, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1675 N National Rd
Ste D
Columbus, IN 47201
Phone (812) 799-1257

1675 N National Rd
Columbus, IN 47201
Phone (812) 799-1257

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

1940 E Tipton St
Ste C
Seymour, IN 47274
Phone (812) 271-0042

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1013563881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 E TIPTON ST STE C",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472743566",
            "telephone_number": "812-271-0042",
            "fax_number": "812-248-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORY",
        "first_name": "SHELBY",
        "middle_name": "B",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013475A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "WALLS",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.