Individual provider Active NPI

Grace C Shen, PT

  • Physical Therapist
  • Crossville, TN
National Provider Identifier
1447437561
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16202 Issued in TN
Practice address
115 Cumberland PLZ
Crossville, TN 38555-4292
Phone
(931) 787-1244
NPI assigned
Jan 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8692 NC
Physical Therapist 225100000X 16202 TN Primary

Addresses

Primary practice location

115 Cumberland PLZ
Crossville, TN 38555-4292

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

136 Flynn Branch Rd
Fletcher, NC 28732-8517
Phone (828) 545-2948

Other identifiers 1

IdentifierTypeStateIssuer
079TYOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050414000324 NC Practitioner - Physical Therapist in Private Practice 0547207250 Reassigns benefits to 1 organization
I20250117002428 TN Practitioner - Physical Therapist in Private Practice 0547207250 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8692NCMDSpeech-Language Pathologist
16202TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Apr 28, 2025 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Apr 28, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Touch Therapy Services LLC Physical Therapist Past Accepting new patients
Canton Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

67 Mountainbrook Rd
Asheville, NC 28805
Phone (828) 258-8787

2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

115 Cumberland Plz
Crossville, TN 38555
Phone (931) 787-1244

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1447437561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CUMBERLAND PLZ",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554292",
            "telephone_number": "931-787-1244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Flynn Branch Rd",
            "address_purpose": "LOCATION",
            "city": "Fletcher",
            "state": "NC",
            "postal_code": "287328517",
            "country_code": "US",
            "telephone_number": "828-545-2948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEN",
        "first_name": "GRACE",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8692",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "079TY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.