Individual provider Active NPI

Shannon Stewart

  • Physical Therapist
  • Shelbyville, TN
National Provider Identifier
1164167409
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1878 N Main St
Shelbyville, TN 37160-2018
Phone
(931) 680-9722
NPI assigned
May 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 TN Primary

Addresses

Primary practice location

1878 N Main St
Shelbyville, TN 37160-2018

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818001451 TN Practitioner - Physical Therapist in Private Practice 0547643884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

100 Hunters LN
Suite 200
Tullahoma, TN 37388-8265
Phone (931) 455-1980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14290TNMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Aug 5, 2022 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince Aug 5, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

1878 N Main St
Shelbyville, TN 37160
Phone (931) 680-9722

100 Hunters Ln
Ste 200
Tullahoma, TN 37388
Phone (931) 455-1980

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1164167409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1878 N MAIN ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602018",
            "telephone_number": "931-680-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.