Kimberly Shanahan Hartley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7261 Issued in SC

Practice address

3851 Commercial Center Dr
Ladson, SC 29456-4146

Phone

(843) 314-5434

Fax

(888) 510-9156

NPI assigned

Mar 12, 2012

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

Other identifiers 1

Other names 1

• Kimberly Michelle Shanahan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tri-County Therapy, LLC

  • Speech-Language Pathologist
  • Ladson, SC
  • NPI 1447591607

  Physical Therapist

  NPD
• Jacksonville Peak Performance Sports & Physical Therapy, L.L.C.

  • Specialist
  • Jacksonville, NC
  • NPI 1164482402
  NPD (past)
• Peak Performance Sports and Physical Therapy, LLC

  • Physical Therapist
  • New Bern, NC
  • NPI 1194714063
  NPD (past)

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1376818260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 COMMERCIAL CENTER DR",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564146",
            "telephone_number": "843-314-5434",
            "fax_number": "888-510-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 COMMERCIAL CENTER DR",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564146",
            "telephone_number": "843-314-5434",
            "fax_number": "888-510-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "KIMBERLY",
        "middle_name": "SHANAHAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-12",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH2737",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SHANAHAN",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sedeia Hanesworth
• Timothy Donald Hanna, NP
• Michelle M Hardin, MS, CCC-SLP
• Taylor Harkey, PT, DPT
• Sydney Harrison, OTR/L
• Haley Livingston Heaton, OTR/L
• Donasia Shakura Hendrix
• Valerie Hengemuhle, OTR/L
• Melinda Hensley, CRNA
• Elizabeth L Hercules, SLP

• Physical Therapist in Ladson, SC
• Providers in Ladson, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.