Active NPI
Shawn Moulis
- Physical Therapist
- Georgetown, KY
National Provider Identifier
1912869207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 009477
- Practice address
- 105 Lawson Dr Ste 4
Georgetown, KY 40324-9696 - Phone
- (502) 642-5400
- Fax
- (502) 642-5411
- NPI assigned
- Nov 25, 2025
- Sex
- Male
- 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 | 009477 | KY | Primary |
Addresses
Primary practice location
105 Lawson Dr Ste 4
Georgetown, KY 40324-9696
Mailing address
1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (726) 202-3039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1650 Lyndon Farm CT
Suite 300
Louisville, KY 40223-4029
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009477 | KY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Hand Therapy | Physical Therapist | Current | Accepting new patients |
| Commonwealth Hand Therapy | Physical Therapist | Current | Accepting new patients |
Locations
105 Lawson Dr
Ste 4
Georgetown, KY 40324
Phone (502) 642-5400
330 Waller Ave
Ste 275
Lexington, KY 40504
Phone (859) 447-8599
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.
-
- Customized Equipment (DME)
- Frankfort, KY
- NPI 1033905724
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1912869207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 LYNDON FARM CT STE 300",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402235005",
"telephone_number": "726-202-3039",
"fax_number": "210-978-5592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 LAWSON DR STE 4",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403249696",
"telephone_number": "502-642-5400",
"fax_number": "502-642-5411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULIS",
"first_name": "SHAWN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-25",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "009477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Georgetown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.