Individual provider Active NPI

Shawn Nolan, PT, DPT

  • Physical Therapist
  • Plymouth, MI
National Provider Identifier
1093671729
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501304266 Issued in MI
Practice address
44191 Plymouth Oaks Blvd Ste 800
Plymouth, MI 48170-2538
Phone
(734) 463-3007
NPI assigned
Dec 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 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 5501304266 MI Primary

Addresses

Primary practice location

44191 Plymouth Oaks Blvd Ste 800
Plymouth, MI 48170-2538

Mailing address

16627B Rougeway St
Livonia, MI 48154-3445
Phone (734) 634-8663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260318000481 MI Practitioner - Physical Therapist in Private Practice 7113401290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ethos Physical Therapy LLCGroup PAC ID 6507235298, 7 clinicians

Practice addresses (Care Compare)

44191 Plymouth Oaks Blvd
Suite 800
Plymouth, MI 48170-2538
Phone (734) 463-3007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501304266MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ethos Physical Therapy LLC Physical Therapist CurrentSince Jan 24, 2026 Accepting new patients

Locations

44191 Plymouth Oaks Blvd
Ste 800
Plymouth, MI 48170
Phone (734) 259-7102

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": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1093671729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16627B ROUGEWAY ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543445",
            "telephone_number": "734-634-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44191 PLYMOUTH OAKS BLVD STE 800",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702538",
            "telephone_number": "734-463-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "SHAWN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501304266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.