Individual provider Active NPI

Andrea Cox Shukla, PT

  • Physical Therapist
  • Carlisle, PA
National Provider Identifier
1013944131
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016337 Issued in PA
Practice address
850 Walnut Bottom Rd
Suite 306
Carlisle, PA 17013-3632
Phone
(717) 241-2211
Fax
(717) 241-2240
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016337 PA Primary
Physical Therapist 225100000X DAPT0001305 PA

Addresses

Primary practice location

850 Walnut Bottom Rd
Suite 306
Carlisle, PA 17013-3632

Mailing address

850 Walnut Bottom Rd
Suite 306
Carlisle, PA 17013-3632
Phone (717) 241-2211

Other identifiers 1

IdentifierTypeStateIssuer
098790U30OtherPAMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060303000414 PA Practitioner - Physical Therapist in Private Practice 4385650001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Spine Physical TherapyGroup PAC ID 1153386214, 3 clinicians

Practice addresses (Care Compare)

850 Walnut Bottom Rd
Suite 306
Carlisle, PA 17013-3615
Phone (717) 241-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DAPT0001305PAMDPhysical Therapist
PT016337PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Spine Physical Therapy Physical Therapist CurrentSince Jan 5, 2009 Accepting new patients

Locations

850 Walnut Bottom Rd
Ste 306
Carlisle, PA 17013
Phone (717) 241-2211

Organizations & group practices 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1013944131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD",
            "address_2": "SUITE 306",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133632",
            "telephone_number": "717-241-2211",
            "fax_number": "717-241-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD",
            "address_2": "SUITE 306",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133632",
            "telephone_number": "717-241-2211",
            "fax_number": "717-241-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "ANDREA",
        "middle_name": "COX",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016337",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "DAPT0001305",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "098790U30",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.