Individual provider Active NPI

Shelley Eileen Frost, DPT

  • Physical Therapist
  • Goshen, IN
National Provider Identifier
1063200186
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05010981A Issued in IN
Practice address
2222 Rieth Blvd
Goshen, IN 46526-5868
Phone
(574) 875-9616
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05010981A IN Primary

Addresses

Primary practice location

2222 Rieth Blvd
Goshen, IN 46526-5868

Mailing address

21529 Maple Glen Dr
Edwardsburg, MI 49112-8700
Phone (574) 250-5089

Other names 1

  • Shelley Eileen Roberts Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250808001686 IN Practitioner - Physical Therapist in Private Practice 9931607090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Health LLCGroup PAC ID 1254690530, 32 clinicians

Practice addresses (Care Compare)

2222 Rieth Blvd
Suite 103
Goshen, IN 46526-5869
Phone (574) 875-9616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Health, LLC Physical Therapist CurrentSince Jul 27, 2025 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients
Beacon Health, LLC Past Accepting new patients

Locations

2222 Rieth Blvd
Ste 103
Goshen, IN 46526
Phone (574) 875-9616

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

1815 E Ireland Rd
#100
South Bend, IN 46614
Phone (574) 647-5790

Organizations & group practices 3

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1063200186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21529 MAPLE GLEN DR",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491128700",
            "telephone_number": "574-250-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 RIETH BLVD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265868",
            "telephone_number": "574-875-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "SHELLEY",
        "middle_name": "EILEEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010981A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "ROBERTS",
            "middle_name": "EILEEN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.