Active NPI
Jean M Shannon, PT
- Orthopedic Physical Therapist
- Cincinnati, OH
National Provider Identifier
1760760722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 02640
- Practice address
- 5557 Cheviot Rd
Cincinnati, OH 45247-7020 - Phone
- (513) 923-1700
- Fax
- (513) 741-6631
- NPI assigned
- Jul 25, 2011
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 02640 | OH | Primary |
Addresses
Primary practice location
5557 Cheviot Rd
Cincinnati, OH 45247-7020
Mailing address
5557 Cheviot Rd
Cincinnati, OH 45247-7020
Phone (513) 923-1700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0779171 | Medicaid | OH | |
| 366642 | Other | OH | MEDICARE |
Other names 1
- Jean M Fox
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02640 | OH | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guenthner Physical Therapy Inc | Past | Accepting new patients | |
| Center for Advanced Spine Technologies, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Cincinnati, OH
- NPI 1114114089
-
- Orthopaedic Surgery of the Spine Physician
- Florence, KY
- NPI 1720224959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311552000000",
"number": "1760760722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5557 CHEVIOT RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452477020",
"telephone_number": "513-923-1700",
"fax_number": "513-741-6631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5557 CHEVIOT RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452477020",
"telephone_number": "513-923-1700",
"fax_number": "513-741-6631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "JEAN",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-25",
"last_updated": "2011-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "OH",
"license": "02640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0779171",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "366642",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JEAN",
"last_name": "FOX",
"middle_name": "M",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.