Individual provider Active NPI

Shelby Paige Farmer, PT

  • Physical Therapist
  • San Angelo, TX
National Provider Identifier
1922538271
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1290621 Issued in TX
Practice address
4450 Sunset Dr
San Angelo, TX 76901-5611
Phone
(325) 658-1511
Fax
(325) 481-8599
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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 1290621 TX Primary

Addresses

Primary practice location

4450 Sunset Dr
San Angelo, TX 76901-5611

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 4

IdentifierTypeStateIssuer
1290602OtherTXLICENSE
587820YKRYOtherTXPTAN
378273201MedicaidTX
9878518OtherTXCERTIFIED STRENGTH & CONDITIONING SPECIALIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170812000129 TX Practitioner - Physical Therapist in Private Practice 1052682804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1290621TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Jun 20, 2017 Accepting new patients
Shannon Clinic CurrentSince Jun 20, 2017 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

4450 Sunset Dr
San Angelo, TX 76901
Phone (325) 481-2286

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1922538271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769015611",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "SHELBY",
        "middle_name": "PAIGE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1290621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1290602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "587820YKRY",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378273201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED STRENGTH & CONDITIONING SPECIALIST",
            "identifier": "9878518",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.