Active NPI
Mary Leta Shavers
- Physical Therapist
- Shelbyville, TN
National Provider Identifier
1316094154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5839
- Practice address
- 920 Colloredo Blvd
Shelbyville, TN 37160-2779 - Phone
- (931) 684-3024
- Fax
- (931) 684-3066
- NPI assigned
- Jan 4, 2007
- Last updated
- May 23, 2023
- 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 | 5839 | TN | Primary |
Addresses
Primary practice location
920 Colloredo Blvd
Shelbyville, TN 37160-2779
Mailing address
920 Colloredo Blvd
Shelbyville, TN 37160-2779
Phone (931) 684-3024
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 |
|---|---|---|---|
| 5839 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Center, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1316094154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 COLLOREDO BLVD",
"city": "SHELBYVILLE",
"state": "TN",
"postal_code": "371602779",
"telephone_number": "931-684-3024",
"fax_number": "931-684-3066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 COLLOREDO BLVD",
"city": "SHELBYVILLE",
"state": "TN",
"postal_code": "371602779",
"telephone_number": "931-684-3024",
"fax_number": "931-684-3066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVERS",
"first_name": "MARY",
"middle_name": "LETA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "5839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, TN
- Jordan L Schlabach, DPT
- Samuel Paul Sells Jr., MD
- Seven Springs Orthopaedics, PC
- Kathy Lynn Shamblin, OD
- Sharon Stocking MD PC
- Shelbyville Bedford County Senior Citizens Center
- Shelbyville Cardiology, LLC
- Shelbyville Center for Nursing and Rehabilitation LLC
- Shelbyville Clinic Corp (Shelbyville Orthopedics and Sports Medicine)
- Shelbyville Clinic Corp (Shelbyville Women's Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.