Kelly Sue Shak, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013653L Issued in PA

Practice address

318 Town Center Blvd
Easton, PA 18040-8366

Phone

(610) 253-3300

Fax

(610) 253-1118

NPI assigned

Jul 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Miss Kelly Sue Finken Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advance Physical Therapy, P.C.

  • Physical Therapist
  • Easton, PA
  • NPI 1013940899
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700819570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CHASE HOLLOW DR",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180648104",
            "telephone_number": "610-746-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 TOWN CENTER BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180408366",
            "telephone_number": "610-253-3300",
            "fax_number": "610-253-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAK",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013653L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01133501",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00028342",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1700430",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FINKEN",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bhartesh Shah, M.D.
• Nimish P Shah, PT
• Prakashchandra N Shah, MD
• Revans Shah
• Brian C Shak, M.S.P.T.
• Nadine Shandor, M.S, LPC
• Om Prakash Sharma, M.D.
• Somya Sharma, DO
• Sorabh Sharma, M.D
• Sharon Elwell, PSYD, LLC

• Physical Therapist in Easton, PA
• Providers in Easton, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.