Individual provider Active NPI

Shawna Mulvihill, PT, DPT

  • Physical Therapist
  • Kalamazoo, MI
National Provider Identifier
1023519691
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018221 Issued in MI
Practice address
7125 Stadium Dr
Kalamazoo, MI 49009-4943
Phone
(269) 492-6575
Fax
(269) 492-6577
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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 5392 OK
Physical Therapist 225100000X 5501018221 MI Primary

Addresses

Primary practice location

7125 Stadium Dr
Kalamazoo, MI 49009-4943

Mailing address

7125 Stadium Dr
Kalamazoo, MI 49009-4943
Phone (269) 492-6575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621003445 MI Practitioner - Physical Therapist in Private Practice 6709329469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7125 Stadium Dr
Kalamazoo, MI 49009-4943
Phone (269) 492-6575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5392OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital CurrentSince Jul 10, 2024 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince Jul 10, 2024 Accepting new patients

Locations

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

7125 Stadium Dr
Kalamazoo, MI 49009
Phone (269) 492-6575

Organizations & group practices 2

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1023519691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490094943",
            "telephone_number": "269-492-6575",
            "fax_number": "269-492-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490094943",
            "telephone_number": "269-492-6575",
            "fax_number": "269-492-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVIHILL",
        "first_name": "SHAWNA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5392",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.