Active NPI
Nelly Shaw-McMinn, D.P.T.
- Physical Therapist
- San Diego, CA
National Provider Identifier
1295080307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39088
- Practice address
- 12171 World Trade Dr
San Diego, CA 92128-3709 - Phone
- (858) 217-2137
- NPI assigned
- Jul 16, 2012
- 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 | 39088 | CA | Primary |
Addresses
Primary practice location
12171 World Trade Dr
San Diego, CA 92128-3709
Mailing address
12171 World Trade Dr
San Diego, CA 92128-3709
Phone (858) 217-2137
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 |
|---|---|---|---|
| 39088 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beth Scalone PT, Inc | Physical Therapist | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342396800000",
"number": "1295080307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12171 WORLD TRADE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283709",
"telephone_number": "858-217-2137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12171 WORLD TRADE DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283709",
"telephone_number": "858-217-2137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW-MCMINN",
"first_name": "NELLY",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-16",
"last_updated": "2012-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.