Shoreline Docks Incorpprated

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3409 Issued in TN

Legal business name

SHORELINE DOCKS INCORPPRATED

Practice address

7905 Cody LN
Knoxville, TN 37938-3172

Phone

(865) 776-1063

NPI assigned

Mar 3, 2008

Organization subpart

Yes

Parent organization

MAX POTENTIAL REHAB INCAs reported in NPPES

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

Authorized official

Name

Jason Martin, LPTA

Title

Owner

Phone

(865) 776-1063

Specialties & licenses 9

Addresses

Part of

Shoreline Docks Incorpprated

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1730359126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70188",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379380188",
            "telephone_number": "865-776-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7905 CODY LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379383172",
            "telephone_number": "865-776-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE DOCKS INCORPPRATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAX POTENTIAL REHAB INC",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-776-1063",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "TN",
            "license": "3409",
            "primary": false
        },
        {
            "code": "2251H1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Human Factors",
            "state": "TN",
            "license": "3409",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": "TN",
            "license": "3409",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "TN",
            "license": "3409",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "3409",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "3409",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "TN",
            "license": "3409",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Shook, PHARMD
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• Brittany Booker Shope
• Catherine Boyd Shope, P.T.
• Shora Foundation
• Adam Tyler Short, M.D.
• Blair P Short
• Catherine Malia Short, PHARMD
• William Charles Short, PA-C
• David Michael Shott, LPTA

• Physical Therapy Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.