Shane Henderson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

034331 Issued in NY

Practice address

30 Hatfield LN
Suite 203
Goshen, NY 10924-6766

Phone

(845) 615-2222

Fax

(845) 615-2224

NPI assigned

Oct 4, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1619251006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HATFIELD LN",
            "address_2": "SUITE 203",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246766",
            "telephone_number": "845-615-2222",
            "fax_number": "845-615-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HATFIELD LN",
            "address_2": "SUITE 203",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246766",
            "telephone_number": "845-615-2222",
            "fax_number": "845-615-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SHANE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Jo-Ann Healey
• Healthspine and Anesthesia Institute
• Healthy Living, PC
• Joan Hearn-Parks, LCSW
• Madline M Helms, COTA
• Robert Charles Hendler, MD
• Kayla Pennington Henke, LMSW, CASAC
• Patricia Hennessey, LCSW
• Kelly Lynn Hennessy
• Jeanne T Herbert, MS

• Physical Therapist in Goshen, NY
• Providers in Goshen, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.