Eric Vaughn Shawl, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24166 Issued in MD

Practice address

65 Thomas Johnson Dr Ste D
Frederick, MD 21702-4371

Phone

(301) 663-7898

NPI assigned

Nov 11, 2024

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

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spring Ridge Physical TherapyGroup PAC ID 1850363185, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spring Ridge Physical Therapy

  dba Superior Physical Therapy and Sports Rehab

  • Physical Therapist
  • Frederick, MD
  • NPI 1790808855
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1508680281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 THOMAS JOHNSON DR STE D",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024371",
            "telephone_number": "301-663-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 THOMAS JOHNSON DR STE D",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024371",
            "telephone_number": "301-663-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAWL",
        "first_name": "ERIC",
        "middle_name": "VAUGHN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Shatzer
• Marsha Rosaura Shaw, MD
• Michaela Shaw
• Raymond Shaw, L.AC
• Tiffany L Shaw, LCSW-C
• Michelle B Shay, LCSW
• Preston Kevin Shay
• Jessica Shea
• Mary Ellen Shea
• Ronda K Sheaffer

• Physical Therapist in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.