Shawn Erlene Prosser, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2008027451 Issued in MO

Practice address

7451 SE Anderson LN
Lathrop, MO 64465-8586

Phone

(785) 741-0621

NPI assigned

Jul 9, 2012

Last updated

Jul 9, 2012By 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 names 1

• Shawn Erlene Rahe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1730444555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7451 SE ANDERSON LANE",
            "city": "LATHROP",
            "state": "MO",
            "postal_code": "64465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 SE ANDERSON LN",
            "city": "LATHROP",
            "state": "MO",
            "postal_code": "644658586",
            "telephone_number": "785-741-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "SHAWN",
        "middle_name": "ERLENE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2008027451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWN",
            "last_name": "RAHE",
            "middle_name": "ERLENE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John W Huddart DDS LLC (Lathrop Dental Care)
• Lathrop Chiropractic Center Inc.
• Lathrop R-II School District
• Natalie Loyd
• Elizabeth Ann Pierson-Poe
• Malena Whitt, BCBA, LBA
• Laura Wood

• Physical Therapy Assistant in Lathrop, MO
• Providers in Lathrop, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; 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.