Shannon Bruce Harris, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT 24206 Issued in CA

Practice address

9665 Wilshire Blvd
#222
Beverly Hills, CA 90212-2340

Phone

(310) 247-8414

Fax

(310) 247-9414

NPI assigned

Nov 16, 2010

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Body Reform Physical Therapies, Inc.

  • Physical Therapy Clinic/Center
  • Beverly Hills, CA
  • NPI 1669774014
  NPD (past)

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1437450830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9665 WILSHIRE BLVD",
            "address_2": "#222",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122340",
            "telephone_number": "310-247-8414",
            "fax_number": "310-247-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9665 WILSHIRE BLVD",
            "address_2": "#222",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902122340",
            "telephone_number": "310-247-8414",
            "fax_number": "310-247-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SHANNON",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 24206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Harris, PSY.D.
• Jillion T. Harris, MD
• Kristin Harris, MPAP
• Lindsay R Harris, O.D.
• Marcus Duane Harris, RN
• Sue Sue Harris, PH.D.
• William Crawford Harris, M.D.
• Harry M, Miller, M.D., Inc.
• Harry Marshak, M.D., a Professional Medical Corporation
• Hartford Anesthesia Group Inc

• Orthopedic Physical Therapist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.