Active NPI
Shannon S. Arrieta, MPT
- Physical Therapist
- Union Grove, WI
National Provider Identifier
1255409934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10635-024
- Practice address
- 1201 Main St
Union Grove, WI 53182-1303 - Phone
- (262) 878-9602
- Fax
- (262) 878-9609
- NPI assigned
- Dec 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10635-024 | WI | Primary |
Addresses
Primary practice location
1201 Main St
Union Grove, WI 53182-1303
Mailing address
3601 30TH Ave Ste 103
Kenosha, WI 53144-1642
Phone (262) 657-0222
Other names 1
- Shannon S. Fait
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10635 | WI | MD | Ambulatory Care Pharmacist |
| 10635-024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports Physical Therapy & Rehabilitation Specialists S.C. | Physical Therapist | Past | Accepting new patients |
| Sports Physical Therapy & Rehab Specialists, S.C. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Athletico Physical Therapy
- Physical Therapist
- Kenosha, WI
- NPI 1326150624
-
dba Athletico Physical Therapy
- Clinic/Center
- Mukwonago, WI
- NPI 1174187975
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255409934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 30TH AVE STE 103",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441642",
"telephone_number": "262-657-0222",
"fax_number": "262-657-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 MAIN ST",
"city": "UNION GROVE",
"state": "WI",
"postal_code": "531821303",
"telephone_number": "262-878-9602",
"fax_number": "262-878-9609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARRIETA",
"first_name": "SHANNON",
"middle_name": "S.",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10635-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "FAIT",
"middle_name": "S.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Union Grove, WI
- Laura J. Acompanado, MSSW, LCSW
- Advantage PT & Sports Rehab LLC (CORA Physical Therapy - Union Grove)
- Elizabeth M Armstrong
- Athletico LTD (Athletico Physical Therapy)
- Aurora Medical Group, Inc.
- Aurora Pharmacy, Inc. (Aurora Pharmacy)
- Margaret E Baker, PA-C
- Balance of Mind Counseling and Behavioral Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.