Active NPI
Shawn Lynn Peters, PTA
- Physical Therapy Assistant
- Springfield, OH
National Provider Identifier
1275919078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 07010
- Practice address
- 1500 Villa Rd
Springfield, OH 45503-1656 - Phone
- (937) 342-8424
- NPI assigned
- Aug 4, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 07010 | OH | Primary |
Addresses
Primary practice location
1500 Villa Rd
Springfield, OH 45503-1656
Mailing address
21 E Cecil St
Springfield, OH 45504-2215
Phone (937) 215-7446
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07010 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438646400000",
"number": "1275919078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 E CECIL ST",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455042215",
"telephone_number": "937-215-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 VILLA RD",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455031656",
"telephone_number": "937-342-8424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "SHAWN",
"middle_name": "LYNN",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-04",
"last_updated": "2015-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "07010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.