Individual provider Active NPI

Patrick L Shumrick, DPT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1215901673
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04938 Issued in OH
Practice address
4815 Cooper Rd Ste 102
Cincinnati, OH 45242-7076
Phone
(513) 891-0934
Fax
(513) 891-1323
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT04938 OH Primary

Addresses

Primary practice location

4815 Cooper Rd Ste 102
Cincinnati, OH 45242-7076

Mailing address

PO Box 30155
Cincinnati, OH 45230-0155
Phone (513) 891-0934

Other identifiers 1

IdentifierTypeStateIssuer
2376549MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000416 OH Practitioner - Physical Therapist in Private Practice 6305820424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9402 Towne Square Ave
Suite C45242
Blue Ash, OH 45242-6909
Phone (513) 505-7319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT04938OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Balance Related Disorders and Rehabilitation Inc CurrentSince Sep 2, 2002 Accepting new patients

Locations

9402 Towne Square Ave
Ste C
Blue Ash, OH 45242
Phone (513) 891-0934

9402 Towne Square Ave
Ste C45242
Blue Ash, OH 45242
Phone (513) 231-2700

7685 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 231-2700

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1215901673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30155",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452300155",
            "telephone_number": "513-891-0934",
            "fax_number": "513-891-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 COOPER RD STE 102",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452427076",
            "telephone_number": "513-891-0934",
            "fax_number": "513-891-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMRICK",
        "first_name": "PATRICK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT04938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2376549",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.