Individual provider Active NPI

Shawn Nash, DPT

  • Physical Therapist
  • Manchester, CT
National Provider Identifier
1396223368
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11910 Issued in CT
Practice address
360 Tolland Tpke Ste 2E
Manchester, CT 06042-1759
Phone
(860) 643-5317
NPI assigned
Aug 1, 2018
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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 11910 CT Primary

Addresses

Primary practice location

360 Tolland Tpke Ste 2E
Manchester, CT 06042-1759

Mailing address

360 Tolland Tpke Ste 2E
Manchester, CT 06042-1759
Phone (860) 643-5317

Other identifiers 1

IdentifierTypeStateIssuer
11910OtherCTCONNECTICUT PHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727000765 CT Practitioner - Physical Therapist in Private Practice 9931581790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anb-Ptsma Holdings IncGroup PAC ID 4789572926, 190 clinicians

Practice addresses (Care Compare)

44 Dale Rd
Suite 203
Avon, CT 06001-4351
Phone (860) 674-1713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11910CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Jul 5, 2022 Accepting new patients
Ptsma Inc Past Accepting new patients

Locations

44 Dale Rd
Ste 203
Avon, CT 06001
Phone (860) 674-1713

1151 Tolland Tpke
Ste 9
Manchester, CT 06042
Phone (860) 288-1014

103 E Main St
Unit C
Plainville, CT 06062
Phone (860) 517-8885

47 N Main St
West Hartford, CT 06107
Phone (860) 409-4595

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1396223368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 TOLLAND TPKE STE 2E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421759",
            "telephone_number": "860-643-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 TOLLAND TPKE STE 2E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421759",
            "telephone_number": "860-643-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "SHAWN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "11910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT PHYSICAL THERAPY LICENSE",
            "identifier": "11910",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.