Shapes Physical Therapy & Wellness Clinic LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SHAPES PHYSICAL THERAPY & WELLNESS CLINIC LLC

Practice address

19441 Golf Vista PLZ Ste 110
Leesburg, VA 20176-8270

Phone

(509) 212-9661

NPI assigned

Feb 2, 2024

Organization subpart

No

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

Authorized official

Name

Shaista Ambreen

Title

Chief Executive Officer

Phone

(509) 212-9661

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1790548642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FERNDALE TER NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764872",
            "telephone_number": "509-212-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19441 GOLF VISTA PLZ STE 110",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768270",
            "telephone_number": "509-212-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPES PHYSICAL THERAPY & WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "AMBREEN",
        "authorized_official_first_name": "SHAISTA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "509-212-9661"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahriar Shahzeidi, MD
• Ashlee Shain
• Adel Shakerian, PHARMD
• Erin Shanahan, OT
• Allison Shanley
• Helia Sharif
• Anil Kumar Sharma, MD
• Durga Pokhrel Sharma
• Indu Sharma
• Farhan Shaukat, AG-ACNP

• Physical Therapist in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.