Shannon R Lopiccolo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013750 Issued in IL

Practice address

507 E Armstrong Ave
Peoria, IL 61603-3201

Phone

(309) 686-7755

Fax

(309) 686-7722

NPI assigned

Dec 5, 2007

Last updated

Sep 27, 2010By 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Easter Seals - Ucp

  • Behavior Analyst
  • Peoria, IL
  • NPI 1083983738
  NPD (past)
• Easter Seals - Ucp

  • Voluntary or Charitable Agency
  • Peoria, IL
  • NPI 1467434795

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1225210800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 E ARMSTRONG AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033201",
            "telephone_number": "309-686-7755",
            "fax_number": "309-686-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 E ARMSTRONG AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033201",
            "telephone_number": "309-686-7755",
            "fax_number": "309-686-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPICCOLO",
        "first_name": "SHANNON",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Long
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• Lori Bushell Counseling LLC
• Tamara Marie Lott, LCPC, CRC
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• Carol Sue Loughridge, PTA
• Howard Allen Love, MA LCPC

• Physical Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.