Shannon Lee Hassan, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

012747-01 Issued in NY

Practice address

29 Creeden Hill Rd
Middletown, NY 10940-6897

Phone

(845) 537-6878

NPI assigned

Nov 2, 2022

Last updated

Nov 2, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1508573130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CREEDEN HILL RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406897",
            "telephone_number": "845-537-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 CREEDEN HILL RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109406897",
            "telephone_number": "845-537-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012747-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Paige Harris, MD
• Kerry Ann Harris, MS CCC/SLP
• Tunya Denise Harris, LCSW-R
• Juana Harvey
• Yusif Hasan, MD
• Sherell Rebecca Hassell-Robinson
• Norma Haughton, LPN
• Evan James Hawkins, M.D. MBA
• Lorraine Hawkins, OTR
• Morgan Elizabeth Hawley

• Physical Therapy Assistant in Middletown, NY
• Providers in Middletown, NY by specialty
• Physical Therapy Assistant in New York

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