Shannon Henry, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2649 Issued in OK

Practice address

717 S Mission St
Sapulpa, OK 74066-4659

Phone

(918) 227-7878

NPI assigned

Mar 16, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1174108609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721018",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704786",
            "telephone_number": "918-270-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S MISSION ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664659",
            "telephone_number": "918-227-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "SHANNON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Jaymes Henderson
• Taylor Hendricks
• Heather Henrichsen
• Samantha Marie Henry-Ranger, LPC
• Margaret Henry
• Carol Izell Hensley-Case, LMSW
• Marie Antoinette Henson, LPN
• Dianne Hernandez
• Whitney Allison Hicks, LPC
• Larry Wayne Higgs, O.D.

• Physical Therapy Assistant in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.