Active NPI
Cori Shank, PT
- Cardiopulmonary Physical Therapist
- Indianapolis, IN
National Provider Identifier
1659754430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiopulmonary Physical Therapist
- License
- 05007836A
- Practice address
- 1701 N Senate Blvd
Indianapolis, IN 46202-1239 - Phone
- (317) 962-8847
- NPI assigned
- Jun 30, 2015
- Last updated
- Jun 30, 2015
- 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 |
|---|---|---|---|---|
| Cardiopulmonary Physical Therapist | 2251C2600X | 05007836A | IN | Primary |
Addresses
Primary practice location
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Mailing address
250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219-4959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7721 Battery Pointe Way
My 360 Wellness
Indianapolis, IN 46240-1090
Phone (866) 360-9355
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05007836A | IN | MD | Cardiopulmonary Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Wellness Team LLC | Current | Accepting new patients |
Locations
4411 Park Place Dr
Fort Wayne, IN 46845
Phone (260) 205-8451
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435622400000",
"number": "1659754430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"address_2": "STE 130",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N SENATE BLVD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021239",
"telephone_number": "317-962-8847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANK",
"first_name": "CORI",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-30",
"last_updated": "2015-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251C2600X",
"taxonomy_group": "",
"desc": "Physical Therapist, Cardiopulmonary",
"state": "IN",
"license": "05007836A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.