Active NPI
Nicole Lynne Shreve, MPT
- Physical Therapist
- Clarksburg, WV
National Provider Identifier
1821313404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2048
- Practice address
- 1 Med Center Dr
Clarksburg, WV 26301-4155 - Phone
- (304) 623-3461
- Fax
- (304) 626-7000
- NPI assigned
- Apr 7, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 2048 | WV | Primary |
Addresses
Primary practice location
1 Med Center Dr
Clarksburg, WV 26301-4155
Mailing address
1 Medical Center Dr
Clarksburg, WV 26301-4155
Phone (304) 623-3461
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2048 | WV | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1821313404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263014155",
"telephone_number": "304-623-3461",
"fax_number": "304-626-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MED CENTER DR",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263014155",
"telephone_number": "304-623-3461",
"fax_number": "304-626-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHREVE",
"first_name": "NICOLE",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-07",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "2048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.