Shasta J Ellenburg, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH4042 Issued in AL

Practice address

1254 Andrews Ave
Ozark, AL 36360-3712

Phone

(334) 445-1380

Fax

(334) 445-1489

NPI assigned

Jun 30, 2011

Last updated

Jun 30, 2011By 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

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthactions PAGroup PAC ID 3476535881, 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.65 of 100Reported as individual

Quality

76.46

Improvement activities

40

Cost

72

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthactions PA

  • Physical Therapist
  • Jackson, AL
  • NPI 1467444182
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1104113935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "706-236-2774",
            "fax_number": "706-802-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 ANDREWS AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603712",
            "telephone_number": "334-445-1380",
            "fax_number": "334-445-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBURG",
        "first_name": "SHASTA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH4042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Nicole Dukes, MS, CCC-SLP
• Tracie Dunn, RDN
• Tabatha A Durbin, RBT
• Dva Healthcare Renal Care Inc (Ozark Dialysis)
• Emily Bass Eifert, CCC-SLP
• Encore Rehabilitation Inc (Encore Rehab of Ozark)
• Enlighten Behavioral Consultation, LLC
• Eyecare Associates, Inc. (Eye Care Associates)
• Faith Ministry Trinity Life Family Inc
• Patty Fenn, MS, CCC-SLP

• Physical Therapist in Ozark, AL
• Providers in Ozark, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.