Shannon L O'Hara, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025436-1 Issued in NY

Practice address

357 Bay Rd 4
Queensbury, NY 12804-3051

Phone

(518) 632-4944

Fax

(518) 632-4945

NPI assigned

Jan 14, 2011

Last updated

Jan 7, 2025By 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

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Innova Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Queensbury, NY
  • NPI 1821486481
  Medicare reassignment NPD

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1235434721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 BAY RD 4",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043051",
            "telephone_number": "518-632-4944",
            "fax_number": "518-632-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 BAY RD 4",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043051",
            "telephone_number": "518-632-4944",
            "fax_number": "518-632-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025436-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Country ENT, PC
• North Country Sports Medicine PLLC
• North Country Vision Center
• Helen Margaret Nutt, FNP-C
• Lauren Alexis O'Connor
• O'Leary Chiropractic, PLLC
• Michael J. O'Leary, D.C., C.C.S. P.
• Carissa Elizabeth O'Rourke, OTR/L
• Diane Ohanlon, LCSW-R
• Megan Oldenburger

• Physical Therapist in Queensbury, NY
• Providers in Queensbury, 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 7, 2025; 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.