Active NPI
Shane Tyler Conway, DPT
- Physical Therapist
- Rock Hill, SC
National Provider Identifier
1154888964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10068
- Practice address
- 197 Piedmont Blvd Ste 214
Rock Hill, SC 29732-1846 - Phone
- (803) 909-6447
- NPI assigned
- Feb 28, 2019
- Sex
- Male
- 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 Therapist | 225100000X | 10068 | SC | Primary |
Addresses
Primary practice location
197 Piedmont Blvd Ste 214
Rock Hill, SC 29732-1846
Mailing address
4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2248
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10068 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1154888964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092290",
"telephone_number": "704-323-2248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "197 PIEDMONT BLVD STE 214",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321846",
"telephone_number": "803-909-6447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "SHANE",
"middle_name": "TYLER",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-28",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "10068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.