Individual provider Active NPI

Henry Edison Shih

  • Physical Therapist
  • Glen Burnie, MD
National Provider Identifier
1477155182
Registry record updated Jun 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1338458 Issued in TX
Practice address
1413 Madison Park Dr Ste 100
Glen Burnie, MD 21061-6355
Phone
(443) 583-3757
NPI assigned
Nov 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2023

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 1338458 TX Primary

Addresses

Primary practice location

1413 Madison Park Dr Ste 100
Glen Burnie, MD 21061-6355

Mailing address

1927 Round Lake Dr
Houston, TX 77077-5907
Phone (713) 339-0689

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803003243 MD Practitioner - Physical Therapist in Private Practice 2769894278 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
4 Oaks Physical Therapy, LLC. Physical Therapist CurrentSince Jul 20, 2023 Accepting new patients
Wang&Jiang, MD, PA Current Accepting new patients

Locations

2000 Century Plz
Columbia, MD 21044
Phone (410) 740-4802

10632 Little Patuxent Pkwy
Ste 123
Columbia, MD 21044
Phone (443) 917-2973

1413 Madison Park Dr
Ste 100
Glen Burnie, MD 21061
Phone (443) 583-3757

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.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685836800000",
    "number": "1477155182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 ROUND LAKE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775907",
            "telephone_number": "713-339-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 MADISON PARK DR STE 100",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616355",
            "telephone_number": "443-583-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIH",
        "first_name": "HENRY",
        "middle_name": "EDISON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-09",
        "last_updated": "2023-06-04",
        "certification_date": "2023-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1338458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2023; 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.