Deandre Kelly Shanese Small, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT36881 Issued in FL

Practice address

8477 S Suncoast Blvd
Homosassa, FL 34446-5028

Phone

(352) 448-7857

Fax

(352) 382-7781

NPI assigned

Jun 7, 2021

Last updated

Jun 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab Advantage Solutions, PLLCGroup PAC ID 0749534865, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Rehab Advantage Solutions, PLLC

  dba TMC Therapy at Home

  • Physical Therapist
  • Homosassa, FL
  • NPI 1164908307
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1396312559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8477 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465028",
            "telephone_number": "352-448-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8477 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465028",
            "telephone_number": "352-448-7857",
            "fax_number": "352-382-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "DEANDRE KELLY",
        "middle_name": "SHANESE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Shea
• Tanni Shipp
• Erin Elisabeth Simon
• Kimberly Sipes
• Tonia Skaria
• Amber Smith Joiner
• Adrian Smith, OTA
• Donna Dodson Smith
• Kayla M Smoot
• Claudia Jo Smythe, PTA20579

• Physical Therapist in Homosassa, FL
• Providers in Homosassa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.