Individual provider Active NPI

Shana Lynn Bell, LPTA

  • Physical Therapy Assistant
  • Corinth, MS
National Provider Identifier
1417094095
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA3102 Issued in MS
Practice address
127 Pratt Dr
Corinth, MS 38834-6026
Phone
(662) 284-9838
Fax
(662) 284-9866
NPI assigned
Jan 31, 2007
Last updated
Apr 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Specialist 174400000X PTA3102 MS
Physical Therapy Assistant 225200000X PTA3102 MS Primary

Addresses

Primary practice location

127 Pratt Dr
Corinth, MS 38834-6026

Mailing address

5 Northside Dr
Belmont, MS 38827-9201
Phone (662) 416-1049

Other practice location 1

503 Constitution Dr
Iuka, MS 38852-8201
Phone (662) 424-9500

Other identifiers 1

IdentifierTypeStateIssuer
1487911269MedicaidMS

Other names 1

  • Shana Lynn Graham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA3102MSMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Rehabilitation, LLC PastSince Apr 17, 2020 Accepting new patients

Organizations & group practices 1

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1417094095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NORTHSIDE DR",
            "city": "BELMONT",
            "state": "MS",
            "postal_code": "388279201",
            "telephone_number": "662-416-1049",
            "fax_number": "662-284-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 PRATT DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346026",
            "telephone_number": "662-284-9838",
            "fax_number": "662-284-9866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "503 Constitution Dr",
            "address_purpose": "LOCATION",
            "city": "Iuka",
            "state": "MS",
            "postal_code": "388528201",
            "country_code": "US",
            "telephone_number": "662-424-9500",
            "fax_number": "662-424-9592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELL",
        "first_name": "SHANA",
        "middle_name": "LYNN",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "PTA3102",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA3102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487911269",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "GRAHAM",
            "middle_name": "LYNN",
            "credential": "LPTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.