Active NPI
Kylie R Shields
- Physical Therapy Assistant
- Brookpark, OH
National Provider Identifier
1679407928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA014168
- Practice address
- 16074 Richard Dr
Brookpark, OH 44142-3372 - Phone
- (330) 446-6641
- NPI assigned
- Jun 11, 2026
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA014168 | OH | Primary |
Addresses
Primary practice location
16074 Richard Dr
Brookpark, OH 44142-3372
Mailing address
16074 Richard Dr
Brookpark, OH 44142-3372
Phone (330) 446-6641
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781136000000",
"number": "1679407928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16074 RICHARD DR",
"city": "BROOKPARK",
"state": "OH",
"postal_code": "441423372",
"telephone_number": "330-446-6641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16074 RICHARD DR",
"city": "BROOKPARK",
"state": "OH",
"postal_code": "441423372",
"telephone_number": "330-446-6641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "KYLIE",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-11",
"last_updated": "2026-06-11",
"certification_date": "2026-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "PTA014168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brookpark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.