Katie J Shannon, ATC/LAT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2018032324 Issued in MO

Practice address

1206 N Main St
Mountain Grove, MO 65711-1025

Phone

(417) 926-5699

NPI assigned

Sep 10, 2018

Last updated

Sep 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katieshannon@ptsci.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physical Therapy Specialist Clinic, Inc.

  • Physical Therapist
  • West Plains, MO
  • NPI 1659312619
  NPD

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1619450244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8160 WHETSTONE RD",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657112553",
            "telephone_number": "832-318-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111025",
            "telephone_number": "417-926-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KATIE",
        "middle_name": "J",
        "credential": "ATC/LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2018032324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vallie Jo Rogers, PT
• Nadatha Shenade Rutz
• Samuel E Deatherage DMD PC
• Shannon Chiropractic LLC
• Christopher Shannon, DC
• Deborah Ann Shockley, L.P.C.
• Jeremy Ryan Skeen, P.T.
• Francis Louise Smith, ADMINISTRATOR
• Spurling and White LLC (Grove Family Care)
• St Johns Clinic Inc (SJC-Mountain Grove)

• Physical Medicine & Rehabilitation Physician in Mountain Grove, MO
• Providers in Mountain Grove, MO by specialty
• Physical Medicine & Rehabilitation Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.