Individual provider Active NPI

Shawn Lee Mains, PT

  • Physical Therapist
  • Oshkosh, WI
National Provider Identifier
1063487098
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4369-024 Issued in WI
Practice address
909 S Washburn St
Oshkosh, WI 54904-8051
Phone
(920) 235-8966
Fax
(920) 235-1526
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 4369-024 WI Primary

Addresses

Primary practice location

909 S Washburn St
Oshkosh, WI 54904-8051

Mailing address

909 S Washburn St
Oshkosh, WI 54904-8051
Phone (920) 235-8966

Other identifiers 1

IdentifierTypeStateIssuer
40221500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130001416 WI Practitioner - Physical Therapist in Private Practice 4981890449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fletcher Chiropractic Office CurrentSince Oct 11, 2021 Accepting new patients

Locations

440 N Koeller St
Oshkosh, WI 54902
Phone (920) 230-2525

Organizations & group practices 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063487098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966",
            "fax_number": "920-235-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048051",
            "telephone_number": "920-235-8966",
            "fax_number": "920-235-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINS",
        "first_name": "SHAWN",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4369-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40221500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.