Individual provider Active NPI

Shelly Howerton, PTA

  • Physical Therapy Assistant
  • Kirksville, MO
National Provider Identifier
1720759202
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2009018573 Issued in MO
Practice address
1705 E Laharpe St
Kirksville, MO 63501-3927
Phone
(660) 341-3565
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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 2009018573 MO Primary

Addresses

Primary practice location

1705 E Laharpe St
Kirksville, MO 63501-3927

Mailing address

1502 E Scott St
Kirksville, MO 63501-3871
Phone (660) 341-3565

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
2009018573MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1720759202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 E SCOTT ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013871",
            "telephone_number": "660-341-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E LAHARPE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013927",
            "telephone_number": "660-341-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWERTON",
        "first_name": "SHELLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2009018573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.