Active NPI
Shana Lynn Bell, LPTA
- Physical Therapy Assistant
- Corinth, MS
National Provider Identifier
1417094095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA3102
- 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, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487911269 | Medicaid | MS |
Other names 1
- Shana Lynn Graham
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA3102 | MS | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Rehabilitation, LLC | Past | 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.
-
- Rehabilitation Clinic/Center
- Belmont, MS
- NPI 1669814687
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.