Active NPI
Cheryl Shannon, PT
- Physical Therapist
- Peachtree City, GA
National Provider Identifier
1609933167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT000768
- Practice address
- 1401 Georgian Park
Suite 220
Peachtree City, GA 30269-6973 - Phone
- (770) 487-1931
- NPI assigned
- Jan 3, 2007
- 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 | PT000768 | GA | Primary |
Addresses
Primary practice location
1401 Georgian Park
Suite 220
Peachtree City, GA 30269-6973
Mailing address
PO Box 6890
Evansville, IN 47719-0890
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT000768 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609933167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6890",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477190890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 GEORGIAN PARK",
"address_2": "SUITE 220",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302696973",
"telephone_number": "770-487-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "CHERYL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT000768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.