Active NPI
Robert Shirley
- Physical Therapist
- Germantown, MD
National Provider Identifier
1184025322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21551
- Practice address
- 20500 Seneca Meadows Parkway
Germantown, MD 20876 - Phone
- (301) 961-8500
- NPI assigned
- Sep 8, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21551 | MA | Primary |
| Physical Therapist | 225100000X |
Addresses
Primary practice location
20500 Seneca Meadows Parkway
Germantown, MD 20876
Mailing address
143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200
Other practice location 1
143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21551 | MA | MD | Physical Therapist |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Norwell, MA
- NPI 1669411856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1184025322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 LONGWATER DR",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611683",
"telephone_number": "781-878-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20500 SENECA MEADOWS PARKWAY",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "20876",
"telephone_number": "301-961-8500"
}
],
"practiceLocations": [
{
"address_1": "143 Longwater Dr",
"address_purpose": "LOCATION",
"city": "Norwell",
"state": "MA",
"postal_code": "020611683",
"country_code": "US",
"telephone_number": "781-878-5200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIRLEY",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-08",
"last_updated": "2021-01-20",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "21551",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.