Shane Ledrew Fink, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 2554 Issued in AR

Practice address

1801 Forest Hills Blvd
205
Bella Vista, AR 72715-3016

Phone

(479) 855-9348

Fax

(479) 855-9358

NPI assigned

Sep 19, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mountaincrest Rehab of Bella Vista, Inc.

  • Physical Therapist
  • Bella Vista, AR
  • NPI 1932165982
  NPD (past)

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1477835213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13511 ROBBINS RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628003",
            "telephone_number": "479-530-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD",
            "address_2": "205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153016",
            "telephone_number": "479-855-9348",
            "fax_number": "479-855-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "SHANE",
        "middle_name": "LEDREW",
        "name_prefix": "Mr.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-19",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA 2554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ruiz Eudey, CD, CLC, RYT
• Eye Associates Leasing Company Incorporated (Boozman-Hof Optical)
• Faith Venture Pharmacy Inc (Medicap Pharmacy)
• Feet Plus of Arkansas Inc
• Sarah Fellers
• Madison Forthman, PHARM D
• Jason Paul Frederick, RN
• Katherine Frey, CBS
• Aubyn Rene Friedland, FNP
• Gary F Frigon, MD

• Physical Therapy Assistant in Bella Vista, AR
• Providers in Bella Vista, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.