NPIMap

Individual provider Active NPI

Andrea Marie Shanafelt, MSPT

  • Physical Therapist
  • Ephrata, PA
National Provider Identifier
1760629398
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017331 Issued in PA
Practice address
136 Lake St
Ephrata, PA 17522-2415
Phone
(717) 738-7979
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017331 PA Primary

Addresses

Primary practice location

136 Lake St
Ephrata, PA 17522-2415

Mailing address

1491 Jerry LN
Manheim, PA 17545-9351

Other names 1

  • Andrea Marie Young Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001532 PA Practitioner - Physical Therapist in Private Practice 6709238231 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1760629398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 JERRY LN",
            "city": "MANHEIM",
            "state": "PA",
            "postal_code": "175459351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 LAKE ST",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175222415",
            "telephone_number": "717-738-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAFELT",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "YOUNG",
            "middle_name": "MARIE",
            "credential": "MSPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.