Individual provider Active NPI

Shannon Wyant, DPT

  • Physical Therapist
  • Waynesboro, VA
National Provider Identifier
1235801887
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214609 Issued in VA
Practice address
760 Town Center Dr Ste B
Waynesboro, VA 22980-9266
Phone
(540) 943-2222
Fax
(540) 466-8061
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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 2305214609 VA Primary

Addresses

Primary practice location

760 Town Center Dr Ste B
Waynesboro, VA 22980-9266

Mailing address

504 Albemarle SQ
Charlottesville, VA 22901-7405
Phone (434) 817-7848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011001043 VA Practitioner - Physical Therapist in Private Practice 4789082454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy at AcacGroup PAC ID 7214907211, 52 clinicians

Practice addresses (Care Compare)

1015 Heathercroft Cir
Suite 200
Crozet, VA 22932-3370
Phone (434) 817-4283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305214609VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy at Acac Physical Therapist CurrentSince Aug 22, 2021 Accepting new patients
Physical Therapy at Acac CurrentSince Aug 22, 2021 Accepting new patients
Physical Therapy at Acac Physical Therapist PastSince Oct 17, 2021 Accepting new patients

Locations

504 Albemarle Sq
Charlottesvle, VA 22901
Phone (434) 817-7848

1015 Heathercroft Cir
Ste 200
Crozet, VA 22932
Phone (434) 817-4283

Organizations & group practices 3

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": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1235801887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 ALBEMARLE SQ",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229017405",
            "telephone_number": "434-817-7848",
            "fax_number": "434-465-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 TOWN CENTER DR STE B",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229809266",
            "telephone_number": "540-943-2222",
            "fax_number": "540-466-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYANT",
        "first_name": "SHANNON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.