Active NPI
Shannon Marie Roskamp, PT, DPT, MSA
- Physical Therapist
- Weidman, MI
National Provider Identifier
1598084667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501014675
- Practice address
- 50 N Coldwater Rd
Suite D
Weidman, MI 48893-8845 - Phone
- (989) 546-7490
- Fax
- (989) 546-7298
- NPI assigned
- May 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501014675 | MI | Primary |
Addresses
Primary practice location
50 N Coldwater Rd
Suite D
Weidman, MI 48893-8845
Mailing address
50 N Coldwater Rd
Ste D
Weidman, MI 48893-8845
Phone (989) 546-7490
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501014675 | Other | MI | STATE LICENSE |
Other names 1
- Shannon Marie Kauffman
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Isabella Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Assistant
- Weidman, MI
- NPI 1376952853
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490659200000",
"number": "1598084667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 N COLDWATER RD",
"address_2": "STE D",
"city": "WEIDMAN",
"state": "MI",
"postal_code": "488938845",
"telephone_number": "989-546-7490",
"fax_number": "989-563-5953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 N COLDWATER RD",
"address_2": "SUITE D",
"city": "WEIDMAN",
"state": "MI",
"postal_code": "488938845",
"telephone_number": "989-546-7490",
"fax_number": "989-546-7298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSKAMP",
"first_name": "SHANNON",
"middle_name": "MARIE",
"credential": "PT, DPT, MSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-27",
"last_updated": "2017-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501014675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "5501014675",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "KAUFFMAN",
"middle_name": "MARIE",
"credential": "PT, DPT, MSA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Weidman, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.