Shawna Mae Charlton, PTA – Physical Therapy Assistant

Key facts

NPI: 1235501933
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: 007261 (NY)
Practice address: 56 Market St
Potsdam, NY 13676-1747
Phone: (315) 265-4065
NPI assigned: Oct 21, 2015
Sex: Female
Sole proprietor: No

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.

Health Services of Northern New York Home Health Agency · Potsdam, NY · NPI 1952407033

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
007261	NY	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Health Services of Northern New York		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	007261	NY	Yes

Addresses

Primary practice location

56 Market St
Potsdam, NY 13676-1747

Mailing address

1859 Ford St
Ogdensburg, NY 13669-1845
Phone (315) 323-3913

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 21, 2015.

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1235501933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 FORD ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136691845",
            "telephone_number": "315-323-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MARKET ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761747",
            "telephone_number": "315-265-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "SHAWNA",
        "middle_name": "MAE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "007261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

All providers in Potsdam, NY · Physical Therapy Assistant in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.