Individual provider Active NPI

Shannon Elizabeth Kelly, PT, DPT

  • Physical Therapist
  • Medina, OH
National Provider Identifier
1932090537
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021871 Issued in OH
Practice address
2736 Medina Rd Ste 108
Medina, OH 44256-9801
Phone
(330) 867-2240
NPI assigned
Jul 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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 PT021871 OH Primary

Addresses

Primary practice location

2736 Medina Rd Ste 108
Medina, OH 44256-9801

Mailing address

134 3Rd St NW
New Philadelphia, OH 44663-3761
Phone (330) 987-3884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT021871OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Language Learning Associates, LLC Physical Therapist PastSince Jul 13, 2025 Accepting new patients

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": "1752192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1932090537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 3RD ST NW",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446633761",
            "telephone_number": "330-987-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 MEDINA RD STE 108",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569801",
            "telephone_number": "330-867-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHANNON",
        "middle_name": "ELIZABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.