Cny Shine Physical Occupational and Speech Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CNY SHINE PHYSICAL OCCUPATIONAL AND SPEECH THERAPY PLLC

Practice address

3400 Vickery Rd Ste E
North Syracuse, NY 13212-4526

Phone

(315) 806-0756

NPI assigned

Oct 6, 2023

Organization subpart

No

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

Authorized official

Name

Amanda Miller, DPTNPI 1932765641

Title

Partner/Owner/DPT

Phone

(315) 806-0756

Specialties & licenses 3

Addresses

Other names 2

• Shine Pediatric Therapy Doing business as
• Shine Physical Therapy PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Miller, PHYSICAL THERAPIST

  • Physical Therapist
  • North Syracuse, NY
  • NPI 1932765641
  Medicare reassignment NPD Authorized official
• Madison Bell, MS OTR/L

  • Occupational Therapist
  • Hannibal, NY
  • NPI 1699491589
  Medicare reassignment NPD
• Katelyn Labrie, DPT

  • Physical Therapist
  • Syracuse, NY
  • NPI 1396524914

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1851172779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 VICKERY RD STE E",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124534",
            "telephone_number": "315-214-4482",
            "fax_number": "315-299-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 VICKERY RD STE E",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132124526",
            "telephone_number": "315-806-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CNY SHINE PHYSICAL OCCUPATIONAL AND SPEECH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-06",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PARTNER/OWNER/DPT",
        "authorized_official_telephone_number": "315-806-0756",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shine Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shine Physical Therapy PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kathleen Clark
• Nicole Elizabeth Clark, LMSW
• Elizabeth C Close, LMHC-D
• Cny Marriage & Family Therapy Place
• Cny Quality Transport,LLC
• Debra A Cole X, LMT
• Melissa Compton
• Emily Cornell
• Heather Cullen
• Danielle Marie Cunningham, D.D.S.

• Physical Therapist in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.