Individual provider Active NPI

Andrea Souza Costa-Sheahan, RPT

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1477732121
Registry record updated Sep 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501013317 Issued in MI
Practice address
504 SE 31St Ter
Cape Coral, FL 33904-3472
Phone
(239) 673-8179
Fax
(239) 347-3914
NPI assigned
Oct 30, 2007
Last updated
Sep 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2018

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 5501013317 MI Primary
Physical Therapist 225100000X PT28137 FL

Addresses

Primary practice location

504 SE 31St Ter
Cape Coral, FL 33904-3472

Mailing address

504 SE 31St Ter
Cape Coral, FL 33904-3472
Phone (239) 673-8179

Other practice location 1

7800 W Outer Dr
Suite #250
Detroit, MI 48235-3461
Phone (313) 362-9445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28137FLMDPhysical Therapist
5501013317MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Rehab Services, P.C. Physical Therapist Past Accepting new patients
United Rehab Services, P.C. Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537660800000",
    "number": "1477732121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 SE 31ST TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339043472",
            "telephone_number": "239-673-8179",
            "fax_number": "239-347-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SE 31ST TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339043472",
            "telephone_number": "239-673-8179",
            "fax_number": "239-347-3914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7800 W Outer Dr",
            "address_2": "Suite #250",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482353461",
            "country_code": "US",
            "telephone_number": "313-362-9445",
            "fax_number": "313-362-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTA-SHEAHAN",
        "first_name": "ANDREA",
        "middle_name": "SOUZA",
        "name_prefix": "Ms.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2018-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013317",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2018; 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.