Active NPI
Shannon Clifford, PT
- Physical Therapist
- Northfield, NJ
National Provider Identifier
1023168697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01382700
- Practice address
- 611 New Rd
Northfield, NJ 08225-1669 - Phone
- (609) 645-2514
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT015941 | PA | |
| Physical Therapist | 225100000X | 40QA01382700 | NJ | Primary |
Addresses
Primary practice location
611 New Rd
Northfield, NJ 08225-1669
Mailing address
611 New Rd
Northfield, NJ 08225-1669
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1060416 | Other | WV | WORKERS COMP |
| 1418430 | Other | PA | HIGHMARK |
| 0019168370003 | Medicaid | PA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT015941 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292198400000",
"number": "1023168697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 NEW RD",
"city": "NORTHFIELD",
"state": "NJ",
"postal_code": "082251669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 NEW RD",
"city": "NORTHFIELD",
"state": "NJ",
"postal_code": "082251669",
"telephone_number": "609-645-2514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIFFORD",
"first_name": "SHANNON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2010-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT015941",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01382700",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMP",
"identifier": "1060416",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "1418430",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019168370003",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northfield, NJ
- Chiropractic and Rehab Exercise Center Carecenter of S Jersey North
- Ciarra Ciarricco, PA-C
- Susan Ciofalo, LSW
- Heather M Clark, D.M.D.
- Marichelle Que Claveria
- Community Options Enterprises, Inc.
- Community Quest Cedar Bridge
- Community Surgical Supply of Toms River LLC
- Brian Condon Jr., BRIAN CONDON LCSW
- Gabriel Conley
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.