Individual provider Active NPI

Michelle Susann Shegogue, MSPT

  • Physical Therapist
  • Fredericksburg, VA
National Provider Identifier
1366658338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305204825 Issued in VA
Practice address
10401 Spotsylvania Ave
Suite 201
Fredericksburg, VA 22408-8606
Phone
(540) 741-3770
Fax
(540) 741-3775
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305204825 VA Primary

Addresses

Primary practice location

10401 Spotsylvania Ave
Suite 201
Fredericksburg, VA 22408-8606

Mailing address

8494 Gray Fox LN
King George, VA 22485-3571
Phone (540) 775-4991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621000474 VA Practitioner - Physical Therapist in Private Practice 2668851759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Marymount University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2800 Welford St
Fredericksburg, VA 22401-3176
Phone (540) 361-1830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince May 1, 2022 Accepting new patients
Mary Washington Healthcare Physicians Physical Therapist CurrentSince May 1, 2022 Accepting new patients

Locations

2800 Wellford St
Ste 100
Fredericksburg, VA 22401

10401 Spotsylvania Ave
Ste 201
Fredericksburg, VA 22408
Phone (540) 741-3770

9530 Cosner Dr
Ste 101
Fredericksburg, VA 22408

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366658338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8494 GRAY FOX LN",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853571",
            "telephone_number": "540-775-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 SPOTSYLVANIA AVE",
            "address_2": "SUITE 201",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088606",
            "telephone_number": "540-741-3770",
            "fax_number": "540-741-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEGOGUE",
        "first_name": "MICHELLE",
        "middle_name": "SUSANN",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.