Individual provider Active NPI

Angela Lynn Shick, PT/ATC

  • Physical Therapist
  • Marysville, OH
National Provider Identifier
1821411729
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-8663 Issued in OH
Practice address
500 London Ave
Marysville, OH 43040-5512
Phone
(937) 578-2261
Fax
(937) 578-2827
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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 PT-8663 OH Primary

Addresses

Primary practice location

500 London Ave
Marysville, OH 43040-5512

Mailing address

500 London Ave
Marysville, OH 43040-5512
Phone (937) 578-2261

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

LicenseStateTypeSpecialty
PT-8663OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1821411729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LONDON AVE",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430405512",
            "telephone_number": "937-578-2261",
            "fax_number": "937-578-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LONDON AVE",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430405512",
            "telephone_number": "937-578-2261",
            "fax_number": "937-578-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHICK",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT/ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-8663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.

Verify at the official NPI Registry.