Individual provider Active NPI

Shanna J Paopao, PT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1902020605
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1843 Issued in NE
Practice address
2504 S 119TH St
Omaha, NE 68144-2947
Phone
(402) 932-8686
Fax
(402) 932-8677
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 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 1843 NE Primary

Addresses

Primary practice location

2504 S 119TH St
Omaha, NE 68144-2947

Mailing address

3508 N 150TH Ave
Omaha, NE 68116-6183
Phone (402) 709-0803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131219001516 NE Practitioner - Physical Therapist in Private Practice 7618104639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2504 S
119TH
Omaha, NE 68144-2947

2504 S 119TH St
Omaha, NE 68144-2947
Phone (402) 932-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1843NEMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bodywise Therapy PC Physical Therapist CurrentSince Jul 23, 2013 Accepting new patients

Locations

2504 S 119th St
Omaha, NE 68144
Phone (402) 932-8686

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1902020605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 N 150TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681166183",
            "telephone_number": "402-709-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 S 119TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442947",
            "telephone_number": "402-932-8686",
            "fax_number": "402-932-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOPAO",
        "first_name": "SHANNA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.