Individual provider Active NPI

Shanna Nicole Sibiski, DPT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1679853105
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23694 Issued in MD
Practice address
2300 Garrison Blvd
Suite 190
Baltimore, MD 21216-2335
Phone
(410) 566-2501
Fax
(410) 566-3025
NPI assigned
Aug 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23694 MD Primary

Addresses

Primary practice location

2300 Garrison Blvd
Suite 190
Baltimore, MD 21216-2335

Mailing address

2300 Garrison Blvd
Suite 190
Baltimore, MD 21216-2335
Phone (410) 566-2501

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Miller Rehabilitation Associates LLC Physical Therapist CurrentSince Oct 10, 2021 Accepting new patients

Locations

20 Crossroads Dr
Ste 13
Owings Mills, MD 21117
Phone (410) 363-0015

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": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1679853105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD",
            "address_2": "SUITE 190",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162335",
            "telephone_number": "410-566-2501",
            "fax_number": "410-566-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD",
            "address_2": "SUITE 190",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162335",
            "telephone_number": "410-566-2501",
            "fax_number": "410-566-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBISKI",
        "first_name": "SHANNA",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.