Ketul Shah, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22818 Issued in MA

Practice address

2530 Bobcat Village Center Rd Unit C
North Port, FL 34288

Phone

(941) 426-7400

Fax

(941) 426-7400

NPI assigned

Feb 15, 2017

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

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: ketul.shah.1@9455.direct.athenahealth.com

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.

• Advanced Rehabilitation Inc

  • Physical Therapist
  • Valrico, FL
  • NPI 1427505627
  NPD (past)

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1629517321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 SE 16TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903819",
            "telephone_number": "239-772-2363",
            "fax_number": "239-772-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 BOBCAT VILLAGE CENTER RD UNIT C",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34288",
            "telephone_number": "941-426-7400",
            "fax_number": "941-426-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2530 Bobcat Village Center Rd Unit C",
            "address_purpose": "LOCATION",
            "city": "North Port",
            "state": "FL",
            "postal_code": "34288",
            "country_code": "US",
            "telephone_number": "941-426-7400",
            "fax_number": "941-426-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KETUL",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-15",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Wesley Scott Jr., DPT
• Breanna Seenath
• Taylor Seifferlein
• Patricia Tobin Senger
• Walter Theodore Senick, PHARMACIST
• Breanna Shambles
• Neekaytan Sharma, M.D.
• Samantha Ann Sharp, APRN
• Emily Shehadeh, PHARMD
• Hailee Shelton

• Physical Therapist in North Port, FL
• Providers in North Port, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.