Active NPI
Shana Denise Pearson, PT
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1760449532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5590
- Practice address
- 1100 Blythe Blvd
Charlotte, NC 28203-5814 - Phone
- (704) 355-7760
- NPI assigned
- Apr 27, 2006
- 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 | 5590 | NC | Primary |
Addresses
Primary practice location
1100 Blythe Blvd
Charlotte, NC 28203-5814
Mailing address
6323 Pine Hollow Dr
Charlotte, NC 28212-4550
Phone (704) 258-6331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7211812 | Medicaid | NC |
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 |
|---|---|---|---|
| 5590 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430179200000",
"number": "1760449532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6323 PINE HOLLOW DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282124550",
"telephone_number": "704-258-6331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035814",
"telephone_number": "704-355-7760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "SHANA",
"middle_name": "DENISE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-27",
"last_updated": "2015-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "5590",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7211812",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.