Individual provider Active NPI

Shynna Erxleben

  • Physical Therapy Assistant
  • Aurora, IL
National Provider Identifier
1689382749
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.009639 Issued in IL
Practice address
3493 Ravinia Cir
Aurora, IL 60504-3145
Phone
(863) 934-0264
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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 160.009639 IL Primary

Addresses

Primary practice location

3493 Ravinia Cir
Aurora, IL 60504-3145

Mailing address

3493 Ravinia Cir
Aurora, IL 60504-3145

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
160.009639ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1689382749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3493 RAVINIA CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605043145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 RAVINIA CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605043145",
            "telephone_number": "863-934-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERXLEBEN",
        "first_name": "SHYNNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.009639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.