Individual provider Active NPI

Ann Marie Shaughnessy, PTA

  • Physical Medicine & Rehabilitation Physician
  • Overland Park, KS
National Provider Identifier
1487393195
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
14-03124 Issued in KS
Practice address
10034 W 151St St
Overland Park, KS 66221-9326
Phone
(913) 257-5425
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 14-03124 KS Primary

Addresses

Primary practice location

10034 W 151St St
Overland Park, KS 66221-9326

Mailing address

643 Splitlog Ave
Kansas City, KS 66101-3331
Phone (816) 673-6933

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14-03124KSMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Health Group LLC CurrentSince Jun 5, 2022 Accepting new patients
The Prairie Farmstead CurrentSince Sep 1, 2024 Accepting new patients

Locations

10034 W 151st St
Overland Park, KS 66221
Phone (816) 799-1767

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1487393195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 SPLITLOG AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661013331",
            "telephone_number": "816-673-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10034 W 151ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662219326",
            "telephone_number": "913-257-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KS",
            "license": "14-03124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.