Active NPI
Shaku Madhukar Rao, PTA
- Physical Therapy Assistant
- Cleveland, OH
National Provider Identifier
1124148291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 05630
- Practice address
- 9500 Euclid Ave
Cleveland, OH 44195-0001 - Phone
- (216) 444-6572
- NPI assigned
- Mar 30, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 05630 | OH | Primary |
Addresses
Primary practice location
9500 Euclid Ave
Cleveland, OH 44195-0001
Mailing address
1541 Landsdale Cir
Twinsburg, OH 44087-3337
Phone (330) 405-7143
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 |
|---|---|---|---|
| 05630 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124148291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1541 LANDSDALE CIR",
"city": "TWINSBURG",
"state": "OH",
"postal_code": "440873337",
"telephone_number": "330-405-7143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-444-6572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAO",
"first_name": "SHAKU",
"middle_name": "MADHUKAR",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "05630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.