Shannon Michelle Santiago, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

21320 Issued in FL

Practice address

170 N Center St
Ormond Beach, FL 32174-5186

Phone

(386) 944-4938

NPI assigned

Jul 16, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1376773929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 353306",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321353306",
            "telephone_number": "386-986-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 N CENTER ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745186",
            "telephone_number": "386-944-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "21320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie R Sanchez, ACNP-BC,FNP-BC, ARNP
• Stacyann Ellen Sanders, OTA
• Sandford H Kinne III D O P a
• Adriane Sanitate
• Evelyn V Santiago Gonzalez, CRNA
• Massiel Alexandra Santos Diaz, ARNP
• Sara Kohen Dean DMD PLLC
• Casy J Sargent, PTA
• Sarju Group LLC
• Madison Saunders, MD

• Physical Therapy Assistant in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.