Katina Marie Shockley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

J20000544 Issued in DE

Practice address

1707 Foulk Road
Wilmington, DE 19803

Phone

(302) 856-7462

Fax

(302) 856-7463

NPI assigned

Jun 27, 2007

Last updated

Sep 29, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dynamic Therapy Services of Pennsylvania LLC

  dba Dynamic Physical Therapy

  • Physical Therapist
  • Aston, PA
  • NPI 1346477981
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1093912784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 10TH ST",
            "city": "MARCUS HOOK",
            "state": "PA",
            "postal_code": "190614513",
            "telephone_number": "610-859-8850",
            "fax_number": "610-859-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 FOULK ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19803",
            "telephone_number": "302-856-7462",
            "fax_number": "302-856-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "KATINA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DE",
            "license": "J20000544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Shinn
• David H. Shinnick, PA-C
• Nabeegha Shinwari
• Dennis Shipman, PHD
• David A Shmukler, DC
• Kay Eileen Shoemaker, PT
• Shoprite of Christina Crossing LLC
• Lori Short
• Bruce Showalter
• Michael W Shrader, MD

• Physical Therapy Assistant in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Physical Therapy Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.