Michael Shane Gosnell, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018869 Issued in IL

Practice address

804 S 16TH St
Mattoon, IL 61938-5620

Phone

(217) 460-0910

NPI assigned

Jul 18, 2012

Last updated

Jul 18, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Savoy Therapy Services IncGroup PAC ID 8921260506, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Savoy Therapy Services Inc

  • Physical Therapist
  • Savoy, IL
  • NPI 1992078471
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1699020305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S 16TH ST",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619385620",
            "telephone_number": "217-460-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S 16TH ST",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619385620",
            "telephone_number": "217-460-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSNELL",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitzy A. Golden
• Ashley Rose Goldman, DMD
• James R Goldstein, OD
• Robert G Good, DO
• Mary Elizabeth Gorman, M.D.
• Allyson K. Gough, APRN, BC
• Gowin Enterprises Inc
• Charles Grant, CRNA
• George R Grant, MD
• Kaley Graves, AUD

• Physical Therapist in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.