Individual provider Active NPI

Ryan Matthew Shelton, DPT

  • Physical Therapist
  • Georgetown, KY
National Provider Identifier
1053436196
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
005638 Issued in KY
Practice address
120 N Water St
Georgetown, KY 40324-1354
Phone
(859) 559-7576
NPI assigned
Mar 20, 2007
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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 PT018596 PA
Physical Therapist 225100000X 005638 KY Primary

Addresses

Primary practice location

120 N Water St
Georgetown, KY 40324-1354

Mailing address

120 N Water Street
Georgetown, KY 40324-1354
Phone (859) 559-7576

Other practice location 1

160 Pedro Way
Winchester, KY 40391-8354
Phone (859) 745-2152

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000863 KY Practitioner - Physical Therapist in Private Practice 6507962834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PhilanthroptGroup PAC ID 7113340043, 6 clinicians

Practice addresses (Care Compare)

107 Frazier CT
Suite 2C
Georgetown, KY 40324-9026
Phone (502) 735-1782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005638KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Philanthropt Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients
Winchester Family Practice, PSC Past Accepting new patients
Kentucky Hand and Physical Therapy BC LLC Physical Therapist Past Accepting new patients
Drayer Physical Therapy Kentucky LLC Physical Therapist PastSince Sep 27, 2020 Accepting new patients
Drayer Physical Therapy Institute of Kentucky PLLC Physical Therapist Past Accepting new patients

Locations

107 Frazier Ct
Ste 2C
Georgetown, KY 40324
Phone (502) 735-1782

120 N Water St
Georgetown, KY 40324
Phone (859) 559-7576

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23784/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1053436196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N WATER STREET",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241354",
            "telephone_number": "859-559-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N WATER ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241354",
            "telephone_number": "859-559-7576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Pedro Way",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "KY",
            "postal_code": "403918354",
            "country_code": "US",
            "telephone_number": "859-745-2152",
            "fax_number": "859-745-2153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018596",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.