Individual provider Active NPI

Shannen Drennon, DPT

  • Physical Therapist
  • Wexford, PA
National Provider Identifier
1801340997
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
044407 Issued in NY
Practice address
12311 Perry Hwy
Wexford, PA 15090-8344
Phone
(878) 332-4143
NPI assigned
Aug 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 044407 NY Primary

Addresses

Primary practice location

12311 Perry Hwy
Wexford, PA 15090-8344

Mailing address

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (878) 332-4143

Other practice location 1

109 University Sq
Erie, PA 16541-0002
Phone (814) 871-5300

Other practice location 2

2008 Hudson Ave
Rochester, NY 14617-4361
Phone (585) 467-1420

Other identifiers 1

IdentifierTypeStateIssuer
044407OtherNYPHYSICAL THERAPY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210914001112 PA Practitioner - Physical Therapist in Private Practice 8224363866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044407NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Sep 7, 2021 Accepting new patients
Allegheny Clinic CurrentSince Sep 7, 2021 Accepting new patients
Allegheny Clinic Current Accepting new patients

Locations

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

4 Allegheny Ctr
Fl 7
Pittsburgh, PA 15212

12311 Perry Hwy
Wexford, PA 15090
Phone (878) 332-4143

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1470528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1801340997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908344",
            "telephone_number": "878-332-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908344",
            "telephone_number": "878-332-4143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 University Sq",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165410002",
            "country_code": "US",
            "telephone_number": "814-871-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2008 Hudson Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146174361",
            "country_code": "US",
            "telephone_number": "585-467-1420",
            "fax_number": "585-467-1434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRENNON",
        "first_name": "SHANNEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "044407",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.