Active NPI
Anthony Orr Shaw, PT
- Physical Therapist
- South Burlington, VT
National Provider Identifier
1336255330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040-0002459
- Practice address
- 3 Timber LN
South Burlington, VT 05403-7205 - Phone
- (802) 847-2391
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- 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 | 040-0002459 | VT | Primary |
Addresses
Primary practice location
3 Timber LN
South Burlington, VT 05403-7205
Mailing address
3 Timber LN
South Burlington, VT 05403-7205
Phone (802) 847-2391
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 |
|---|---|---|---|
| 040-0002459 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1336255330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 TIMBER LN",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054037205",
"telephone_number": "802-847-2391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 TIMBER LN",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054037205",
"telephone_number": "802-847-2391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "ANTHONY",
"middle_name": "ORR",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040-0002459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.