Jordan Adam Shettle, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24870 Issued in MD

Practice address

8303 Pulaski Hwy
Ste a
Baltimore, MD 21237-2962

Phone

(443) 372-5300

Fax

(443) 372-5810

NPI assigned

Jul 10, 2012

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 MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Resilient Physiotherapy

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Baltimore, MD
  • NPI 1528614690

  Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1699030262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 GREENLEIGH AVE",
            "address_2": "UNIT 515",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212202038",
            "telephone_number": "717-817-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 PULASKI HWY",
            "address_2": "STE A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212372962",
            "telephone_number": "443-372-5300",
            "fax_number": "443-372-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTLE",
        "first_name": "JORDAN",
        "middle_name": "ADAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Shesiuk
• Ahmed Shetewi
• Kevin N Sheth, M.D.
• Kinjal Sheth, MD
• Sheila Sheth, M.D.
• Aarti Karunakar Shetty
• Alok Atmaram Shetty
• Impana Shetty, MS
• Kirti Shetty, MD
• Megan Nicole Shetz, M.S. CCC-SLP

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.