Individual provider Active NPI

Robert Shirley

  • Physical Therapist
  • Germantown, MD
National Provider Identifier
1184025322
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21551 Issued in MA
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

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20210310000225 MA Practitioner - Physical Therapist in Private Practice 0345656732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21551MAMDPhysical 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.

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.

Verify at the official NPI Registry.