Active NPI
Scott Shaw
- Physical Therapy Assistant
- Cherry Hill, NJ
National Provider Identifier
1487816351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE005157L
- Practice address
- 2 Lucille LN
Cherry Hill, NJ 08003-1031 - Phone
- (386) 756-4395
- Fax
- (866) 426-2811
- NPI assigned
- Jul 1, 2008
- 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 Therapy Assistant | 225200000X | TE005157L | PA | Primary |
Addresses
Primary practice location
2 Lucille LN
Cherry Hill, NJ 08003-1031
Mailing address
917 Beville Rd
Suite G
South Daytona, FL 32119-1712
Phone (386) 756-4395
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
| License | State | Type | Specialty |
|---|---|---|---|
| TE005157L | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1487816351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 BEVILLE RD",
"address_2": "SUITE G",
"city": "SOUTH DAYTONA",
"state": "FL",
"postal_code": "321191712",
"telephone_number": "386-756-4395",
"fax_number": "866-426-2811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 LUCILLE LN",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080031031",
"telephone_number": "386-756-4395",
"fax_number": "866-426-2811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "SCOTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-01",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE005157L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.