Shelly Greenwood
Individual provider Active NPI Physical Therapist · Graceville, FL
NPI 1134524960 · NPPES record last updated Nov 12, 2014
Key facts
- NPI
- 1134524960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT 20833 (FL)
- Practice address
- 5052 Peanut Rd
Graceville, FL 32440-4244 - Phone
- (850) 573-1699
- NPI assigned
- Oct 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellbody Physical Therapy LLC
Practice addresses (Care Compare)
951 Prim Ave
Graceville, FL 32440-2500
Phone (850) 209-3007
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060505000644 | FL | Practitioner - Physical Therapist in Private Practice | 1153332127 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 20833 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellbody Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Chipley Physical Therapy, Inc | Physical Therapist | Past | Accepting new patients |
| Bonifay Physical Therapy | Physical Therapist | Past | Accepting new patients |
Locations
951 Prim Ave
Ste 18
Graceville, FL 32440
Phone (850) 209-3007
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 20833 | FL | Yes |
Addresses
Primary practice location
5052 Peanut Rd
Graceville, FL 32440-4244
Mailing address
5052 Peanut Rd
Graceville, FL 32440-4244
Phone (850) 573-1699
Other providers in Graceville, FL
- Bailey Cooper
- Davis Family Medicine LLC
- Graceville Family Medicine Inc
- Graceville HCC LLC
- Graceville Health Center LLC
- GRNC, LLC
- Rhonda D Hall
- Holmes County Hospital Corporation
- Julie A Hoxie Bowers
- Candice Leigh Hudson
All providers in Graceville, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.