Shawna Rae Sprout, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

28779 Issued in MD

Practice address

1364 Martin Blvd Ste 5
Middle River, MD 21220-4104

Phone

(410) 686-3600

NPI assigned

Feb 7, 2020

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 FL

Enrollment records 1

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.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment NPD
• University Community Hospital, Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1053321919
  NPD (past)

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663977600000",
    "number": "1710519806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 MARTIN BLVD STE 5",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212204104",
            "telephone_number": "410-686-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 MARTIN BLVD STE 5",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212204104",
            "telephone_number": "410-686-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8710 Emge Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212343504",
            "country_code": "US",
            "telephone_number": "410-661-5955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPROUT",
        "first_name": "SHAWNA",
        "middle_name": "RAE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT34907",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren P Simms, P.A.
• Alexis Sims, M.A., ED. S.
• Smile Loft Middle River LLC
• Marissa L Smothers, LCSW-C
• Damilola O Sokefun, RN
• St. Mary'S Efficient Health Care Community Services International Inc
• Sticks R US LLC
• Streams of Clarity LLC
• Strengthening Families Building Communities
• Strive Health Corporation

• Physical Therapist in Middle River, MD
• Providers in Middle River, 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 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.