Shannon Kimbley, P.T.A.
Individual provider Active NPI Physical Therapy Assistant · New Palestine, IN
NPI 1801248398 · NPPES record last updated Jul 7, 2016
Key facts
- NPI
- 1801248398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 06004189A (IN)
- Practice address
- 3362 S Applegate Dr
New Palestine, IN 46163-8937 - Phone
- (317) 501-4059
- NPI assigned
- Jul 7, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06004189A | IN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06004189A | IN | Yes |
Addresses
Primary practice location
3362 S Applegate Dr
New Palestine, IN 46163-8937
Mailing address
3362 S Applegate Dr
New Palestine, IN 46163-8937
Phone (317) 501-4059
Other providers in New Palestine, IN
- Raymond Robert Jennings
- Jessica Johnson
- Judy Hamrock Counseling LLC
- Diana Lynn Kafoure
- Wendy Kihiu
- Katherine Kimmel
- Elijah Koch
- Kristie R Koch
- Jensen Sarae Kornokovich
- Sydney Lane
All providers in New Palestine, IN · Physical Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.