Individual provider Active NPI

Louann Shinn-Evinger, PTA

  • Physical Medicine & Rehabilitation Physician
  • Clearwater, FL
National Provider Identifier
1669744744
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PTA 1158 Issued in FL
Practice address
13830 58TH Street North
Suite 409
Clearwater, FL 33760-3720
Phone
(727) 532-1900
Fax
(727) 532-4300
NPI assigned
Feb 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PTA 1158 FL Primary

Addresses

Primary practice location

13830 58TH Street North
Suite 409
Clearwater, FL 33760-3720

Mailing address

13830 58TH Street North
Suite 409
Clearwater, FL 33760-3720
Phone (727) 532-1900

Other identifiers 1

IdentifierTypeStateIssuer
PTA 1158OtherFLPHYSICAL THERAPY

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

LicenseStateTypeSpecialty
PTA 1158FLMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Physical Therapy and Wellness Inc PastSince Feb 22, 2016 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1669744744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13830 58TH STREET NORTH",
            "address_2": "SUITE 409",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603720",
            "telephone_number": "727-532-1900",
            "fax_number": "727-532-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13830 58TH STREET NORTH",
            "address_2": "SUITE 409",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603720",
            "telephone_number": "727-532-1900",
            "fax_number": "727-532-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINN-EVINGER",
        "first_name": "LOUANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PTA 1158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "PTA 1158",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.