Individual provider Active NPI

Shauna Marie Phillips, PT, DPT

  • Physical Therapist
  • Mountain Top, PA
National Provider Identifier
1609390772
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT026263 Issued in PA
Practice address
100 N Mountain Blvd
Mountain Top, PA 18707-1119
Phone
(570) 474-6100
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 PT026263 PA Primary

Addresses

Primary practice location

100 N Mountain Blvd
Mountain Top, PA 18707-1119

Mailing address

50 Hildebrandt Rd
Dallas, PA 18612-9058

Other practice location 1

87 Oxford St
Hanover Twp, PA 18706-3350
Phone (570) 823-7761

Other practice location 2

1086 Highway 315 Blvd
Wilkes Barre, PA 18702-7012
Phone (570) 823-7761

Other practice location 3

106 Rotary Dr
West Hazleton, PA 18202-1182
Phone (570) 823-7761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231211001270 PA Practitioner - Physical Therapist in Private Practice 8325497795 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steffie Enterprises, IncGroup PAC ID 0840225736, 38 clinicians

Practice addresses (Care Compare)

100 N Mountain Blvd
Mountain Top, PA 18707-1119
Phone (570) 474-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alycam Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Derek Enterprises LLC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Dylan RC Enterprises Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Steffie Enterprises, Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients

Locations

87 Oxford St
Hanover Township, PA 18706
Phone (570) 387-2202

100 N Mountain Blvd
Mountain Top, PA 18707
Phone (570) 474-1171

693 Main St
New Milford, PA 18834
Phone (570) 465-2027

106 Rotary Dr
West Hazleton, PA 18202
Phone (570) 455-2286

1086 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (570) 823-7761

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1609390772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 HILDEBRANDT RD",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186129058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MOUNTAIN BLVD",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071119",
            "telephone_number": "570-474-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 Oxford St",
            "address_purpose": "LOCATION",
            "city": "Hanover Twp",
            "state": "PA",
            "postal_code": "187063350",
            "country_code": "US",
            "telephone_number": "570-823-7761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1086 Highway 315 Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187027012",
            "country_code": "US",
            "telephone_number": "570-823-7761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Rotary Dr",
            "address_purpose": "LOCATION",
            "city": "West Hazleton",
            "state": "PA",
            "postal_code": "182021182",
            "country_code": "US",
            "telephone_number": "570-823-7761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHAUNA",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Top, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.