Individual provider Active NPI

Shannon Stocking

  • Physical Therapy Assistant
  • Saint Louis, MO
National Provider Identifier
1710149281
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160-001933 Issued in IL
Practice address
7733 Forsyth Blvd
2200
Saint Louis, MO 63105-1817
Phone
(815) 694-2176
Fax
(815) 694-2176
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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 160-001933 IL Primary

Addresses

Primary practice location

7733 Forsyth Blvd
2200
Saint Louis, MO 63105-1817

Mailing address

7733 Forsyth Blvd
2200
Saint Louis, MO 63105-1817
Phone (815) 694-2176

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
160-001933ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1710149281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7733 FORSYTH BLVD",
            "address_2": "2200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051817",
            "telephone_number": "815-694-2176",
            "fax_number": "815-694-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 FORSYTH BLVD",
            "address_2": "2200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631051817",
            "telephone_number": "815-694-2176",
            "fax_number": "815-694-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKING",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160-001933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.