Michael Shaddow, PT, DPT, CERT. MDT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1881357861 Issued in NJ

Practice address

1937 Haddonfield Berlin Rd
Cherry Hill, NJ 08003-3737

Phone

(856) 616-0610

NPI assigned

Oct 18, 2021

Last updated

Nov 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vital Performance Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Hainesport, NJ
  • NPI 1629795273
  NPD Authorized official
• Orthopedic and Sports Physical Therapy Services, Inc.

  dba Excel Physical Therapy

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1588661235
  NPD
• Progress Physical Therapy LLC

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1164851085
  NPD

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1881357861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ALLENDALE RD STE 206",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061495",
            "telephone_number": "610-270-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 HADDONFIELD BERLIN RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033737",
            "telephone_number": "856-616-0610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 Woodbourne Rd",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "PA",
            "postal_code": "190571540",
            "country_code": "US",
            "telephone_number": "267-630-5740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADDOW",
        "first_name": "MICHAEL",
        "credential": "PT, DPT, CERT. MDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "1881357861",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT029965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Servidio
• Seventh Street Psychiatry and Wellness, P.C.
• Mohamed Sfaxi, M.D.
• Samara Shabel
• Timothy Thomas Shack, M.D.
• Nihit Shah
• Vidhi Pandya Shah, DMD
• Viral M Shah, OD
• Usman Shahid, MD
• Rivka Shakow, LSW

• Physical Therapist in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.