Melissa M Shaw, P.T.
Individual provider Active NPI Physical Therapist · Chigiak, AK
NPI 1164501565 · NPPES record last updated Dec 12, 2013
Key facts
- NPI
- 1164501565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 499 (AK)
- Practice address
- 22245 Anthem PL
Chigiak, AK 99567-7020 - Phone
- (907) 545-0137
- Fax
- (907) 688-0367
- NPI assigned
- Nov 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 499 | AK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Quest Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 499 | AK | Yes |
Addresses
Primary practice location
22245 Anthem PL
Chigiak, AK 99567-7020
Mailing address
PO Box 671904
Chugiak, AK 99567-1904
Phone (907) 545-0137
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.