Individual provider Active NPI

Benjamin A Shook, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1841594751
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9210 Issued in AZ
Practice address
3945 E Paradise Falls Dr
#109
Tucson, AZ 85712-6683
Phone
(520) 321-0204
Fax
(186) 628-1951
NPI assigned
Jan 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 9210 AZ Primary

Addresses

Primary practice location

3945 E Paradise Falls Dr
#109
Tucson, AZ 85712-6683

Mailing address

PO Box 43085
Tucson, AZ 85733-3085
Phone (520) 321-0204

Other identifiers 1

IdentifierTypeStateIssuer
9210OtherAZ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9210AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomed LLC 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": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841594751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43085",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857333085",
            "telephone_number": "520-321-0204",
            "fax_number": "186-628-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 E PARADISE FALLS DR",
            "address_2": "#109",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126683",
            "telephone_number": "520-321-0204",
            "fax_number": "186-628-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "BENJAMIN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": null,
            "identifier": "9210",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.