Individual provider Active NPI

Shelly Ann Stott, PTA

  • Physical Therapy Assistant
  • Leonardtown, MD
National Provider Identifier
1689219891
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A2598 Issued in MD
Practice address
25480 Point Lookout Rd Ste 200
Leonardtown, MD 20650-3801
Phone
(240) 256-3711
Fax
(240) 256-3612
NPI assigned
Nov 12, 2019
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A2598 MD Primary

Addresses

Primary practice location

25480 Point Lookout Rd Ste 200
Leonardtown, MD 20650-3801

Mailing address

25480 Point Lookout Rd Ste 200
Leonardtown, MD 20650-3801
Phone (240) 256-3711

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
A2598MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1689219891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25480 POINT LOOKOUT RD STE 200",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503801",
            "telephone_number": "240-256-3711",
            "fax_number": "240-256-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25480 POINT LOOKOUT RD STE 200",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503801",
            "telephone_number": "240-256-3711",
            "fax_number": "240-256-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTT",
        "first_name": "SHELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A2598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.