Holly Ann Shaw, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT33187 Issued in FL

Practice address

190 Southpark Circle E
Suite 102
St. Augustine, FL 32086

Phone

(904) 797-2334

NPI assigned

Dec 11, 2017

Last updated

May 30, 2023By 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": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1548775786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LOLLY LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594362",
            "telephone_number": "904-710-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SOUTHPARK CIRCLE E",
            "address_2": "SUITE 102",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-797-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT33187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Sue Shank, R.D.
• Ramzi M Shaqareq, MD
• Shweta Sharma
• Jamie Sharp
• Kayleigh Morgan Shaver, PA-C
• Shazia Bashir MD PLLC (Whole Health Oncology)
• Suzanne Welsh Shea, LCSW
• Paul Sheikewitz, MD
• Shelby H Cline MD PA D/B/a Sunshine Pediatrics of St Augustine
• Megan Shellenberger

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.