Shannon Rae Farrell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05002490A Issued in IN

Practice address

7440 N Shadeland Ave
130
Indianapolis, IN 46250-2029

Phone

(317) 577-7333

Fax

(317) 577-7330

NPI assigned

Apr 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Dynamic Equilibrium, Inc.

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1043332851
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1508039264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 N SHADELAND AVE",
            "address_2": "130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502029",
            "telephone_number": "317-577-7333",
            "fax_number": "317-577-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 N SHADELAND AVE",
            "address_2": "130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502029",
            "telephone_number": "317-577-7333",
            "fax_number": "317-577-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "SHANNON",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002490A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LINCENSE",
            "identifier": "05002490A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nora Farrell, OTD
• Penny Lane Farrell, DPT
• Rowan Farrell, MS, MD
• Samantha A Farrell
• Saundra Farrell, CSFA
• Dione M Farria, MD
• Dustin Michael Farris, PT
• Haley Farris
• Annabelle Lyn Farrow
• Annette Tepner Farthing, DDS

• Physical Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.