Shawn Michael Black, M.S., P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011285 Issued in MI

Practice address

701 US Highway 31 S
Traverse City, MI 49685-8016

Phone

(800) 406-5143

Fax

(231) 995-9302

NPI assigned

Mar 7, 2007

Last updated

May 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EJDADD

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.

• Michigan Pain Consultants PC

  • Pain Medicine (Anesthesiology) Physician
  • Grand Rapids, MI
  • NPI 1467418574
  NPD (past)
• William Sterling Margaret LLC

  dba Excel Rehabilitation Services

  • Physical Therapist
  • Novi, MI
  • NPI 1003946625
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1679603575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 GONDER RD",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 US HIGHWAY 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858016",
            "telephone_number": "800-406-5143",
            "fax_number": "231-995-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.S., P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501011285",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Elizabeth Bischer, NP
• Stephanie Nicole Bishop
• Sonya Biskupski, MS, CCC-SLP
• Elizabeth Anne Renee Black, LLPC
• Jasmine Black
• Roxanne Ranae Blackford
• Brittany Kaye Blackmer
• Bobbi Blakeslee, RN
• Troy J Blasius, ATC
• Kathleen Mhein Blazejewski, LCSW

• Physical Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.