Kelly Shaw, DPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT011691L Issued in PA

Practice address

200 2ND Ave
Kingston, PA 18704-5722

Phone

(570) 288-9315

NPI assigned

Oct 7, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  Geriatrics

  NPD

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1740431915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 2ND AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045722",
            "telephone_number": "570-288-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 2ND AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045722",
            "telephone_number": "570-288-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KELLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "PA",
            "license": "PT011691L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Ian Shafer, LPC
• Jyoti R Shah, M.D. DFAPA
• Hayfa Shakkour-Perez, RT
• Thomas George Sharkey, MD
• Dean Shaver
• Kathleen Sheikh, CRNP
• Ronald Thomas Shevock, DMD
• Martha Shipe, O.D.
• Larry H Shire, DDS
• Robert L. Shmokler, DPM

• Geriatric Physical Therapist in Kingston, PA
• Providers in Kingston, PA by specialty
• Geriatric Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.