Active NPI
Jacquelyn Shaughnessy, RPT
- Geriatric Physical Therapist
- Hixson, TN
National Provider Identifier
1629472402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 5156
- Practice address
- 1224 Cranbrook Dr
Hixson, TN 37343-4804 - Phone
- (423) 309-7202
- Fax
- (423) 309-7202
- NPI assigned
- Oct 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 5156 | TN | Primary |
Addresses
Primary practice location
1224 Cranbrook Dr
Hixson, TN 37343-4804
Mailing address
1224 Cranbrook Dr
Hixson, TN 37343-4804
Phone (423) 309-7202
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 |
|---|---|---|---|
| 5156 | TN | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413936000000",
"number": "1629472402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 CRANBROOK DR",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434804",
"telephone_number": "423-309-7202",
"fax_number": "423-309-7202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 CRANBROOK DR",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434804",
"telephone_number": "423-309-7202",
"fax_number": "423-309-7202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAUGHNESSY",
"first_name": "JACQUELYN",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-22",
"last_updated": "2014-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "TN",
"license": "5156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.