Shannon Hickey, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

012309 Issued in CT

Practice address

15 Riverside Avenue
Bristol, CT 06010

Phone

(508) 468-7682

NPI assigned

Jun 17, 2021

Last updated

Jun 22, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1114595857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PARKER ST APT D106",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922375",
            "telephone_number": "508-468-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RIVERSIDE AVENUE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "508-468-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "SHANNON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": "012309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "shickey@bristolhospital.org",
            "affiliation": "N",
            "address_1": "53 Parker St Apt D106",
            "city": "Wallingford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064922375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopedic Physical Therapist in Bristol, CT
• Providers in Bristol, CT by specialty
• Orthopedic Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.