Shavon A Conerly, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4722 Issued in MS

Practice address

950 E County Line Rd Ste D
Ridgeland, MS 39157-1928

Phone

(601) 899-0002

NPI assigned

Sep 8, 2007

Sex

Female

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

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drayer Physical Therapy Mississippi LLCGroup PAC ID 3274834858, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448
  Medicare reassignment Care Compare group NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  MS, Physical Therapist

  Medicare reassignment NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)
• Therafit, LLC

  • Physical Therapist
  • Hazel Green, AL
  • NPI 1063421857
  NPD (past)

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

{
    "created_epoch": "1189209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1689869174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677285",
            "telephone_number": "615-656-0379",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E COUNTY LINE RD STE D",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571928",
            "telephone_number": "601-899-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Highland Colony Pkwy Ste 2002",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391572075",
            "country_code": "US",
            "telephone_number": "769-300-1101",
            "fax_number": "769-300-1102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONERLY",
        "first_name": "SHAVON",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-08",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH5127",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Committed Care Personal Care Service, LLC
• Committed2Care,LLC
• Compass Medical, LLC
• Compscript, LLC
• R L Conerly Jr., OT
• Jessica Erin Conner, M.S., CCC-SLP
• Mustapha Conteh, RPH
• Converge Inc.
• Courtney Rey Convertino, MD
• Crystal J Cook, LPTA

• Physical Therapist in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.