Active NPI
Jacob Richard Shelow
- Physical Therapist
- Tyrone, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT029728
- Practice address
- 5459 E Pleasant Valley Blvd
Tyrone, PA 16686-8551 - Phone
- (814) 682-7276
- NPI assigned
- Mar 17, 2017
- Last updated
- Aug 18, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT029728 | PA | Primary |
Addresses
Primary practice location
5459 E Pleasant Valley Blvd
Tyrone, PA 16686-8551
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 541-1974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5459 E Pleasant Valley Blvd
Drayer PT Tyrone
Tyrone, PA 16686-8551
Phone (814) 682-7267
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT029728 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drayer Physical Therapy Institute LLC | Physical Therapist | Current | Accepting new patients |
| Drayer Physical Therapy Institute LLC | Physical Therapist | Current | Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
1680 Zion Rd
Bellefonte, PA 16823
Phone (814) 355-5660
152 E Market St
Ste 200
Lewistown, PA 17044
Phone (717) 242-4840
1019 Ghaner Rd
Ste 200
Port Matilda, PA 16870
Phone (814) 954-7056
5459 E Pleasant Valley Blvd
Tyrone, PA 16686
Phone (814) 682-7267
Organizations & group practices 2
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.
-
- Physical Therapist
- Hummelstown, PA
- NPI 1538122700
-
- Physical Therapist
- York, PA
- NPI 1053348409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1467993873",
"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": "423-541-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5459 E PLEASANT VALLEY BLVD",
"city": "TYRONE",
"state": "PA",
"postal_code": "166868551",
"telephone_number": "814-682-7276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELOW",
"first_name": "JACOB",
"middle_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-17",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT029728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyrone, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.