Individual provider Active NPI

Karen Lee Shivers, P.T.

  • Physical Therapist
  • Palm Harbor, FL
National Provider Identifier
1467549386
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 7695 Issued in FL
Practice address
3550 Deer Run S
Palm Harbor, FL 34684-3551
Phone
(727) 480-2809
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 7695 FL Primary

Addresses

Primary practice location

3550 Deer Run S
Palm Harbor, FL 34684-3551

Mailing address

3550 Deer Run S
Palm Harbor, FL 34684-3551
Phone (727) 480-2809

Other identifiers 2

IdentifierTypeStateIssuer
678945596MedicaidFL
881624700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180802002731 FL Practitioner - Physical Therapist in Private Practice 0840548160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 7695FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shivers Enterprises, Inc Physical Therapist CurrentSince May 11, 2018 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1467549386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 DEER RUN S",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843551",
            "telephone_number": "727-480-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 DEER RUN S",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843551",
            "telephone_number": "727-480-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVERS",
        "first_name": "KAREN",
        "middle_name": "LEE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 7695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "678945596",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "881624700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.