Individual provider Active NPI

Shelly Story

  • Physical Therapy Assistant
  • Tampa, FL
National Provider Identifier
1942606850
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
16760 Issued in FL
Practice address
12410 Trotter CT
Tampa, FL 33626-4418
Phone
(352) 585-1811
NPI assigned
Nov 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 16760 FL Primary

Addresses

Primary practice location

12410 Trotter CT
Tampa, FL 33626-4418

Mailing address

12410 Trotter CT
Tampa, FL 33626-4418

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
16760FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1942606850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 TROTTER CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12410 TROTTER CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264418",
            "telephone_number": "352-585-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY",
        "first_name": "SHELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "16760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.