Dongik Shin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011703 Issued in GA

Practice address

2576 Lawrenceville Suwanee Rd
Suwanee, GA 30024-7290

Phone

(770) 962-4043

NPI assigned

Nov 6, 2014

Last updated

Nov 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Emory University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kwon Physical Therapy LLCGroup PAC ID 0941688311, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kwon Physical Therapy LLC

  dba Fit In Motion Physical Therapy

  • Physical Therapist
  • Duluth, GA
  • NPI 1154932200
  Medicare reassignment Care Compare group NPD
• Kiseok Kwon, DPT

  • Physical Therapist
  • Duluth, GA
  • NPI 1508234311
  Medicare reassignment
• Fit in Motion TN LLC

  • Physical Therapist
  • Nashville, TN
  • NPI 1821804154
  NPD (past)

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1730585597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2576 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2576 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247290",
            "telephone_number": "770-962-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DONGIK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Cook Sheridan, NP-C
• Peyton Sheriff, RBT
• Aalya F Sherman, PHARMACIST
• Ling Shi
• John Yozen Shih, D.O.
• Seung Sarah Shin, O.D.
• Sydney Ann Shine, DPT
• Abigail Niersbach Shiotelis, PT, DPT
• Margaret Shiver, LPC
• Taniya Shockley, RBT

• Physical Therapist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.