Individual provider Active NPI

Jennifer Shrewsberry

  • Physical Therapist
  • Greensboro, NC
National Provider Identifier
1861566101
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1401 Benjamin Pkwy
Greensboro, NC 27408-4518
Phone
(336) 854-2929
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Primary

Addresses

Primary practice location

1401 Benjamin Pkwy
Greensboro, NC 27408-4518

Mailing address

3822 Cotswold Ave
Greensboro, NC 27410-8967
Phone (336) 545-1337

Other identifiers 1

IdentifierTypeStateIssuer
P10802OtherNCLICENSE#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628001962 NC Practitioner - Physical Therapist in Private Practice 8820456502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Therapy of North Carolina Inc CurrentSince Apr 16, 2023 Accepting new patients
Proactive Therapy of North Carolina Inc Current Accepting new patients

Locations

10205 US 15 501 Hwy
Unit 24
Southern Pines, NC 28387
Phone (910) 704-5430

2358 US Highway 70
Ste Ab
Swannanoa, NC 28778
Phone (828) 686-3375

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861566101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 COTSWOLD AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108967",
            "telephone_number": "336-545-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BENJAMIN PKWY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084518",
            "telephone_number": "336-854-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREWSBERRY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "P10802",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.