Isabelle N Shoup, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502006457 Issued in MI

Practice address

22180 Pontiac TRL Ste E
South Lyon, MI 48178-9097

Phone

(248) 446-0155

Fax

(248) 446-0177

NPI assigned

Mar 26, 2026

Sex

Female

Sole proprietor

Yes

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 and National Provider Directory roles.

• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Livonia, MI
  • NPI 1689691388
  NPD (past)
• Spine and Extremity Institute of South Lyon, L.L.C.

  • Physical Therapist
  • South Lyon, MI
  • NPI 1811209968

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1774483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1255270138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 PONTIAC TRL STE E",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789097",
            "telephone_number": "248-446-0155",
            "fax_number": "248-446-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 PONTIAC TRL STE E",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789097",
            "telephone_number": "248-446-0155",
            "fax_number": "248-446-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUP",
        "first_name": "ISABELLE",
        "middle_name": "N",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502006457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Shortt, PTA
• Christian J Shortt, DDS
• Juhi Shah Shortt, DDS
• Therese F Shortt, DDS
• William A Shortt, DDS
• Diana Rebecca Silas, DO
• Silverback, Inc.
• Paul L Simon, DDS
• Robin Lynn-Pregitzer Simonton, DDS
• Ajanthan Sivagurunathan, M.D.

• Physical Therapy Assistant in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.