Individual provider Active NPI

Shawna E Kester, PT, DPT

  • Physical Therapist
  • Sterling, IL
National Provider Identifier
1083196307
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.023899 Issued in IL
Practice address
1809 Locust St
Sterling, IL 61081-1101
Phone
(815) 632-5285
Fax
(815) 632-5824
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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 070.023899 IL Primary

Addresses

Primary practice location

1809 Locust St
Sterling, IL 61081-1101

Mailing address

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 632-5285

Other names 1

  • Shawna E Grim Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120000514 IL Practitioner - Physical Therapist in Private Practice 2567716038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.023899ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center Current Accepting new patients
CGH Medical Center CurrentSince Sep 14, 2018 Accepting new patients
CGH Medical Center CurrentSince Sep 14, 2018 Accepting new patients

Locations

2600 Locust St
Sterling, IL 61081
Phone (815) 626-3173

1809 Locust St
Sterling, IL 61081
Phone (815) 564-4002

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1083196307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-632-5285",
            "fax_number": "815-632-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 LOCUST ST",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811101",
            "telephone_number": "815-632-5285",
            "fax_number": "815-632-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTER",
        "first_name": "SHAWNA",
        "middle_name": "E",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.023899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "GRIM",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.