Active NPI
Nicole Shakow
- Specialist
- South Glens Falls, NY
National Provider Identifier
1104193838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 020906-1
- Practice address
- 76 Harrison Ave
South Glens Falls, NY 12803-4912 - Phone
- (518) 783-9048
- NPI assigned
- Nov 23, 2011
- Last updated
- Nov 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 020906-1 | NY | Primary |
Addresses
Primary practice location
76 Harrison Ave
South Glens Falls, NY 12803-4912
Mailing address
9 Quevic Dr
Saratoga Springs, NY 12866-9023
Phone (518) 581-7303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020906-1 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael D. Wood, PT, PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Clifton Park Physical Therapy
- Physical Therapist
- Clifton Park, NY
- NPI 1083664700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1104193838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 QUEVIC DR",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128669023",
"telephone_number": "518-581-7303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 HARRISON AVE",
"city": "SOUTH GLENS FALLS",
"state": "NY",
"postal_code": "128034912",
"telephone_number": "518-783-9048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAKOW",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-23",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "020906-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Glens Falls, NY
- Nurishu Nutrition & Dietetic Services
- Nicole Marie Pelech, PHARM.D.
- Rite Aid of New York Inc (Rite Aid Pharmacy 00648)
- Emily Russom, OTR/L
- Danielle Scacchetti, LPN
- Danielle Shaw
- SJSF Enterprises LLC (neb docs of new york)
- South Glens Falls Central School
- Julie Diane Spoor, SLP
- Stephanie Dechene LCSW-R
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.