Active NPI
Shannessy Sue Michael, P.T.
- Physical Therapist
- Atlantic, IA
National Provider Identifier
1780867903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 03560
- Practice address
- 1500 E 10TH St
Atlantic, IA 50022-1935 - Phone
- (712) 243-8006
- NPI assigned
- Dec 11, 2007
- Last updated
- Sep 20, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 03560 | IA | Primary |
Addresses
Primary practice location
1500 E 10TH St
Atlantic, IA 50022-1935
Mailing address
8217 Parkview Dr
Urbandale, IA 50322-1514
Phone (712) 249-8940
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 |
|---|---|---|---|
| 03560 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1780867903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8217 PARKVIEW DR",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503221514",
"telephone_number": "712-249-8940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E 10TH ST",
"city": "ATLANTIC",
"state": "IA",
"postal_code": "500221935",
"telephone_number": "712-243-8006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "SHANNESSY",
"middle_name": "SUE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-11",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "03560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlantic, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.