Individual provider Active NPI

Christa Marie Shinners, M.S. PT

  • Pediatric Physical Therapist
  • Staten Island, NY
National Provider Identifier
1346485117
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
020214 Issued in NY
Practice address
22 Northern Blvd
Staten Island, NY 10301-4212
Phone
(718) 815-4930
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 020214 NY Primary

Addresses

Primary practice location

22 Northern Blvd
Staten Island, NY 10301-4212

Mailing address

22 Northern Blvd
Staten Island, NY 10301-4212
Phone (718) 815-4930

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
020214NYMDSchool Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1346485117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 NORTHERN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014212",
            "telephone_number": "718-815-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 NORTHERN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014212",
            "telephone_number": "718-815-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNERS",
        "first_name": "CHRISTA",
        "middle_name": "MARIE",
        "credential": "M.S. PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "020214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.