Advance Physical Therapy, P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013574L Issued in PA

Legal business name

ADVANCE PHYSICAL THERAPY, P.C.

Practice address

318 Town Center Blvd
Suite a
Easton, PA 18040-8366

Phone

(610) 253-3300

Fax

(610) 253-1118

NPI assigned

Jul 8, 2006

Organization subpart

No

Name

Mr. Brian C. Shak, PT

Title

Owner

Phone

(610) 253-3300

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kara L Deremer, P.T.

  • Physical Therapist
  • Easton, PA
  • NPI 1942390778
  NPD (past)
• Kelly Sue Shak, PT

  • Physical Therapist
  • Easton, PA
  • NPI 1700819570
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013940899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CHASE HOLLOW DR",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180648104",
            "telephone_number": "610-746-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 TOWN CENTER BLVD",
            "address_2": "SUITE A",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180408366",
            "telephone_number": "610-253-3300",
            "fax_number": "610-253-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-253-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013574L",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013653L",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "AD1436033",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02999500",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5912334",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA1820",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "P11192619",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7618519",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2607186",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE INDEPENDE",
            "identifier": "2120902000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "341-9140",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN OF PA",
            "identifier": "960655",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET",
            "identifier": "0246801",
            "state": "PW"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA MANAGED PLAN",
            "identifier": "7692221",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Ann Ackerman
• Shaunice N Adams
• Arunmozhi Adavan, MD
• Timothy A Adeleye, LPN
• Adelphia Chiropractic Health Center, P.C.
• Advanced Health Chiropractic P.C.
• Advanced Lab Solutions, LLC
• Advanced Radiology and Cardiovascular Center
• Azra Afthab
• Donna J Agulis, RRT, RPSGT

• All providers in Easton, PA
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.