Active NPI
Angelique Shirley, PT
- Physical Therapist
- Wake Forest, NC
National Provider Identifier
1831524388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P10733
- Practice address
- 217 Forbes Rd
Wake Forest, NC 27587-9295 - Phone
- (516) 724-0739
- NPI assigned
- Sep 3, 2013
- 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 | P10733 | NC | Primary |
Addresses
Primary practice location
217 Forbes Rd
Wake Forest, NC 27587-9295
Mailing address
217 Forbes Rd
Wake Forest, NC 27587-9295
Phone (516) 724-0739
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 |
|---|---|---|---|
| P10733 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidsprout Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1831524388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 FORBES RD",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275879295",
"telephone_number": "516-724-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 FORBES RD",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275879295",
"telephone_number": "516-724-0739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "ANGELIQUE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-03",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P10733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.