Charles Shanesy III, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3817 Colonel Glenn Hwy
Beavercreek, OH 45324

Phone

(937) 427-9200

Fax

(513) 755-3762

NPI assigned

Oct 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Abc Pediatric Therapy LLC

  • Physical Therapist
  • West Chester, OH
  • NPI 1134152861
  NPD (past)

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1770034738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7591 TYLERS PLACE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696308",
            "telephone_number": "513-755-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 COLONEL GLENN HWY",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "45324",
            "telephone_number": "937-427-9200",
            "fax_number": "513-755-3762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 N Breiel Blvd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450423868",
            "country_code": "US",
            "telephone_number": "513-420-1700",
            "fax_number": "513-420-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3817 Colonel Glenn Hwy",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "45324",
            "country_code": "US",
            "telephone_number": "937-427-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANESY",
        "first_name": "CHARLES",
        "name_suffix": "III",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-14",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "AB7360731",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2187155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Shade, M.D.
• Maxwell Shafer, MD
• Anjana Hemant Shah, MD
• Mohammed D Shahid, DPM
• Shamim Shamsi, M.D
• Kari Shank
• Briana Sheets, OTD, OTR/L
• Cheli Shelmire
• Sheri Lynn Shepherd, OTR/L
• Katherine Sher, OTD, OTR/L

• Physical Therapist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.