Rodney Shamblin

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

24797 Issued in FL

Practice address

3001 Palm Coast Pkwy SE
Palm Coast, FL 32137-8209

Phone

(386) 446-6060

NPI assigned

Jul 11, 2014

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1922414804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 BROOKHAVEN CT S",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642442",
            "telephone_number": "304-389-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 PALM COAST PKWY SE",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378209",
            "telephone_number": "386-446-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "RODNEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "24797",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "1202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Selim, M.D
• Mostafa A Selim, M.D.
• Sensational Solutional Care LLC
• Traci Serrano, APRN
• Allison Karol Severino, APRN
• Safwan Shams, M.D.
• Bianca Nicole Shaw
• Daniella Shaw
• Dudley Alan Shaw, P.A
• Shawn D Doerrfeld DC PL

• Physical Therapy Assistant in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.