Shawn McHenry, DPT

Individual provider Active NPI Physical Therapist · Crownpoint, NM

NPI 1306386008 · NPPES record last updated Feb 28, 2017

Key facts

NPI
1306386008
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2016003542 (MO)
Practice address
Hwy 371 & Route 9 Junction
Crownpoint, NM 87313
Phone
(505) 786-5291
Fax
(505) 786-6440
NPI assigned
Feb 28, 2017
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170403001330 TX Practitioner - Physical Therapist in Private Practice 8820373905 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2016003542MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pintado Clinic Current
since Feb 21, 2017
Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
Thoreau Clinic Current
since Feb 21, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2016003542 MO Yes

Addresses

Primary practice location

Hwy 371 & Route 9 Junction
Crownpoint, NM 87313

Mailing address

PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-5291

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · Physical Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.