Tanner Shellenbarger
Individual provider Active NPI Physical Therapist · Kenneth City, FL
NPI 1043967722 · NPPES record last updated Mar 3, 2022
Key facts
- NPI
- 1043967722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 4655 66TH St N Ste 22B
Kenneth City, FL 33709-4827 - Phone
- (727) 546-4700
- NPI assigned
- Mar 3, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | FL | Yes |
Addresses
Primary practice location
4655 66TH St N Ste 22B
Kenneth City, FL 33709-4827
Mailing address
11850 Dr Martin Luther King Jr St N Apt 3307
Saint Petersburg, FL 33716-1620
Other providers in Kenneth City, FL
- Liliana Batista Rodriguez
- Hector Julio Rosario
- Gregorio S Santos
- Abey Sarai
- Robert Christopher Saunders
- Chevonne Jass Singh
- Clementie Sinigur
- Sports and Orthopedic Rehabilitation Services Inc
- St Mary Surgical Inc
- St Petersburg Nursing Home, LLC
All providers in Kenneth City, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.