Shannon Koziel, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

26765 Issued in FL

Practice address

901 45TH St
Mangonia Park, FL 33407-2413

Phone

(561) 844-5255

NPI assigned

Jun 26, 2019

Last updated

Jun 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1821659111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16063 RAIN LILLY WAY",
            "city": "WESTLAKE",
            "state": "FL",
            "postal_code": "334706507",
            "telephone_number": "561-644-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZIEL",
        "first_name": "SHANNON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "26765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Mangonia Park, FL
• Providers in Mangonia Park, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.