Individual provider Active NPI

Shannon Leggett, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1588610620
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20293 Issued in NY
Practice address
1395 Lexington Ave
C/O 92ND Street Y, Mezzanine Level
New York, NY 10128-1612
Phone
(646) 707-0400
Fax
(646) 707-0380
NPI assigned
May 26, 2006
Last updated
Sep 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20293 NY Primary

Addresses

Primary practice location

1395 Lexington Ave
C/O 92ND Street Y, Mezzanine Level
New York, NY 10128-1612

Mailing address

1395 Lexington Ave
C/O 92ND Street Y, Mezzanine Level
New York, NY 10128-1612
Phone (646) 707-0400

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
20293NYMDPhysical Therapist
020293NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Leggett Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Back to Sports Physical Therapy, P.C. Physical Therapist PastSince Jul 13, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1588610620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 LEXINGTON AVE",
            "address_2": "C/O 92ND STREET Y, MEZZANINE LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281612",
            "telephone_number": "646-707-0400",
            "fax_number": "646-707-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 LEXINGTON AVE",
            "address_2": "C/O 92ND STREET Y, MEZZANINE LEVEL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281612",
            "telephone_number": "646-707-0400",
            "fax_number": "646-707-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGETT",
        "first_name": "SHANNON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "20293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.