Shannine Banawa Consolacion

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12577 Issued in CT

Practice address

1580 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2869

Phone

(943) 216-2228

NPI assigned

May 28, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Serc Rehabilitation Partners, LLC

  • Physical Therapist
  • Belton, MO
  • NPI 1760745244
  Medicare reassignment Care Compare group NPD
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1063252054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 320",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869",
            "telephone_number": "943-216-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSOLACION",
        "first_name": "SHANNINE",
        "middle_name": "BANAWA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12577",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "0515944A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie K. Connell, CRNA
• Christine Conner, CRNA
• Lyne L Connor, APRN
• Jason Michael Conroe, C.R.N.A.
• Conscious Counseling, Inc.
• Sherly Constant, LCSW,CAP
• Consumer Direct for Florida
• Continental Homecare Services
• Continucare Medical Center
• Continucare Medical Management, Inc.

• Physical Therapist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.