Chandra Shirley, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8362 Issued in MN

Practice address

21395 John Milless Dr
Suite 600
Rogers, MN 55374-4402

Phone

(763) 428-2589

NPI assigned

May 30, 2006

Last updated

Mar 21, 2013By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1598712820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21395 JOHN MILLESS DR",
            "address_2": "SUITE 600",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21395 JOHN MILLESS DR",
            "address_2": "SUITE 600",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744402",
            "telephone_number": "763-428-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "CHANDRA",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8362",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel Schibilla, PA-C
• Elizabeth A Schmidt, P.A.-C
• Seventh Haven Care Services LLC
• Calleen Sher, MS
• Shining Light Care LLC
• Sifana Telehealth & Wellness LLC
• Jodi Lynn Sims, MA LMFT
• Jeffrey Kent Sletten, MPT
• Jeffrey Alan Smith, D.D.S.
• Kevin Jeffery Smith, LMFT

• Physical Therapist in Rogers, MN
• Providers in Rogers, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.