Active NPI
Kimberly Shabino
- Physical Therapist
- Geneseo, IL
National Provider Identifier
1730856972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070025768
- Practice address
- 1225 S Oakwood Ave Ste 1
Geneseo, IL 61254-1990 - Phone
- (309) 944-6447
- NPI assigned
- Aug 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070025768 | IL | Primary |
Addresses
Primary practice location
1225 S Oakwood Ave Ste 1
Geneseo, IL 61254-1990
Mailing address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone (309) 743-2070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230502000352 | IA | Practitioner - Physical Therapist in Private Practice | 3476959263 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rock Valley Physical Therapy Center
Practice addresses (Care Compare)
1700 N Division St
Suite 200
Davenport, IA 52804-3535
Phone (563) 324-2263
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 5
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.
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- NPI 1366724874
-
- Physical Therapist
- West Des Moines, IA
- NPI 1790828457
-
- Occupational Therapist
- Eldridge, IA
- NPI 1881540490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1730856972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 S OAKWOOD AVE STE 1",
"city": "GENESEO",
"state": "IL",
"postal_code": "612541990",
"telephone_number": "309-944-6447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHABINO",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-25",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070025768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Geneseo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.