Shannon Ford, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26179 Issued in FL

Practice address

7195 NW 215TH Way
Starke, FL 32091-5174

Phone

(386) 623-3468

NPI assigned

Dec 18, 2015

Last updated

Dec 18, 2015By the provider in NPPES

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": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1184089005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7195 NW 215TH WAY",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320915174",
            "telephone_number": "386-623-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7195 NW 215TH WAY",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320915174",
            "telephone_number": "386-623-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "SHANNON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis L Ferebee
• Nadine Fiege, DNP, PMHNP-BC
• Marcia Marie Fletcher
• Florida Department of Health (Bradford County Health Department)
• Lynette Fodor
• Brianna N Forsyth
• Dorothy Fox, RPH
• Charles James Franson Jr., D.O.
• Tiffany Jade Harris Fraser, PHARMD
• Amanda Futch, LCSW

• Physical Therapy Assistant in Starke, FL
• Providers in Starke, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.