Christian Shave, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02205600 Issued in NJ

Practice address

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Phone

(315) 772-2778

NPI assigned

Feb 5, 2024

Sex

Male

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1225891971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "315-772-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10263 4th armored division drive",
            "address_purpose": "LOCATION",
            "city": "fort drum",
            "state": "NY",
            "postal_code": "13601",
            "country_code": "US",
            "telephone_number": "732-963-5882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAVE",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02205600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristan I Seok, DPT
• John Sepowitz
• Neel Shah, MD
• Svetlana Claravall Shah, MD
• Stephen Shatinsky, LCSW
• Joseph Shepherd, MS, RD/LD
• Krishna Shrestha, PA
• Kimberlyn Joy Sickler, RDH
• Robert B. Simmonds, PH.D.
• Brady Simpkins, PA-C

• Physical Therapist in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.