Active NPI
Shelby S Willis, DPT
- Physical Therapist
- Slaughter, LA
National Provider Identifier
1841807690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 09636
- Practice address
- 1181 Hwy 432
Slaughter, LA 70777 - Phone
- (225) 306-0030
- NPI assigned
- Sep 25, 2020
- Last updated
- Sep 25, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 09636 | LA | Primary |
Addresses
Primary practice location
1181 Hwy 432
Slaughter, LA 70777
Mailing address
17453 Highway 432
Clinton, LA 70722-4022
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 |
|---|---|---|---|
| 09636 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600992000000",
"number": "1841807690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17453 HIGHWAY 432",
"city": "CLINTON",
"state": "LA",
"postal_code": "707224022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1181 HWY 432",
"city": "SLAUGHTER",
"state": "LA",
"postal_code": "70777",
"telephone_number": "225-306-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "SHELBY",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-25",
"last_updated": "2020-09-25",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "09636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slaughter, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.