Individual provider Active NPI

Danielle Shea, PT

  • Physical Therapist
  • Dunn, NC
National Provider Identifier
1811941545
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4583 Issued in NC
Practice address
721 Tilghman Dr
Suite 100
Dunn, NC 28334-6063
Phone
(910) 892-5635
NPI assigned
May 19, 2006
Last updated
Dec 8, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4583 NC Primary

Addresses

Primary practice location

721 Tilghman Dr
Suite 100
Dunn, NC 28334-6063

Mailing address

2413 Professional Dr
PO Box 7594
Rocky Mount, NC 27804-2254
Phone (252) 443-0808

Other identifiers 6

IdentifierTypeStateIssuer
067W3OtherNCBCBS
198336OtherNCMED RISK
2743631OtherUHC
7385878OtherAETNA
195347OtherMEDCOST
7275569MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060711000372 NC Practitioner - Physical Therapist in Private Practice 3173536331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

721 Tilghman Dr
Suite 100
Dunn, NC 28334-6066
Phone (910) 892-5635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4583NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy Associates LLC CurrentSince Apr 3, 2006 Accepting new patients
Carolina Physical Therapy Associates LLC Physical Therapist CurrentSince Apr 3, 2006 Accepting new patients
Carolina Physical Therapy Associates LLC Current Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Cora North Carolina, LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients

Locations

721 Tilghman Dr
Ste 100
Dunn, NC 28334
Phone (910) 891-4202

721 Tilghman Dr
Ste 200
Dunn, NC 28334
Phone (910) 892-5635

401 Attain St
Ste 121
Fuquay Varina, NC 27526
Phone (252) 443-0808

2413 Professional Dr
Rocky Mount, NC 27804
Phone (252) 443-0808

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1811941545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 PROFESSIONAL DR",
            "address_2": "PO BOX 7594",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042254",
            "telephone_number": "252-443-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 TILGHMAN DR",
            "address_2": "SUITE 100",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283346063",
            "telephone_number": "910-892-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "DANIELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "067W3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED RISK",
            "identifier": "198336",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2743631",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7385878",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "195347",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7275569",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.