Individual provider Active NPI

Shannon Carrie Garcia, P.T., D.P.T.

  • Physical Therapist
  • Escondido, CA
National Provider Identifier
1104330638
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293951 Issued in CA
Practice address
215 S Hickory St Ste 112
Escondido, CA 92025-4360
Phone
(760) 737-8460
Fax
(760) 739-5669
NPI assigned
Nov 20, 2017
Last updated
Nov 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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 293951 CA Primary

Addresses

Primary practice location

215 S Hickory St Ste 112
Escondido, CA 92025-4360

Mailing address

23632 Atex CT
Ramona, CA 92065-4521
Phone (760) 484-6309

Other names 1

  • Shannon Carriet Meng Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731002808 OR Practitioner - Physical Therapist in Private Practice 3072870880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Works, IncGroup PAC ID 0345289757, 14 clinicians

Practice addresses (Care Compare)

2115 NE Wyatt CT
Suite 103
Bend, OR 97701-7679
Phone (541) 382-2070

330 NE Marshall Ave
Bend, OR 97701-4346
Phone (541) 383-8179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293951CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Works, Inc Physical Therapist CurrentSince Sep 11, 2023 Accepting new patients
Physical Therapy Works, Inc Physical Therapist PastSince Apr 9, 2024 Accepting new patients

Locations

2115 NE Wyatt Ct
Ste 103
Bend, OR 97701
Phone (541) 382-2070

330 NE Marshall Ave
Bend, OR 97701
Phone (541) 383-8179

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1104330638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23632 ATEX CT",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920654521",
            "telephone_number": "760-484-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST STE 112",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254360",
            "telephone_number": "760-737-8460",
            "fax_number": "760-739-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "SHANNON",
        "middle_name": "CARRIE",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MENG",
            "middle_name": "CARRIET",
            "credential": "P.T., D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.