Active NPI
Shannon Speagle, D.P.T.
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1316273444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8254
- Practice address
- 7654 N 19TH Ave
Phoenix, AZ 85021-7025 - Phone
- (602) 336-6883
- NPI assigned
- Oct 23, 2009
- 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 | 8254 | AZ | Primary |
Addresses
Primary practice location
7654 N 19TH Ave
Phoenix, AZ 85021-7025
Mailing address
7654 N 19TH Ave
Phoenix, AZ 85021-7025
Phone (602) 336-6883
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 |
|---|---|---|---|
| 8254 | AZ | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Pain Clinic PLLC | 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.
-
- Clinic/Center
- Phoenix, AZ
- NPI 1912138918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325203200000",
"number": "1316273444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7654 N 19TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217025",
"telephone_number": "602-336-6883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7654 N 19TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850217025",
"telephone_number": "602-336-6883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAGLE",
"first_name": "SHANNON",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-23",
"last_updated": "2011-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "8254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.