Active NPI
Shannon Rena Ayers, DPT
- Pediatric Physical Therapist
- Longview, TX
National Provider Identifier
1740613835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 3537
- Practice address
- 450 E. Loop 281
Suite B1
Longview, TX 75601 - Phone
- (903) 757-7731
- Fax
- (903) 757-3756
- NPI assigned
- Aug 13, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1228752 | TX | |
| Pediatric Physical Therapist | 2251P0200X | 3537 | AR | Primary |
Addresses
Primary practice location
450 E. Loop 281
Suite B1
Longview, TX 75601
Mailing address
450 E. Loop 281
Suite B1
Longview, TX 75601
Phone (903) 757-7731
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 194886721 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3537 | AR | MD | Oral & Maxillofacial Surgery (D.M.D.) |
| 1228752 | TX | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H2 Health and Rehabilitation Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- Longview, TX
- NPI 1790165009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532476800000",
"number": "1740613835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 E. LOOP 281",
"address_2": "SUITE B1",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "75601",
"telephone_number": "903-757-7731",
"fax_number": "903-757-3756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 E. LOOP 281",
"address_2": "SUITE B1",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "75601",
"telephone_number": "903-757-7731",
"fax_number": "903-757-3756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYERS",
"first_name": "SHANNON",
"middle_name": "RENA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-13",
"last_updated": "2018-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "TX",
"license": "1228752",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AR",
"license": "3537",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "194886721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.