Shannon M Smith, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10951 Issued in OH

Practice address

16844 Saint Clair Ave
East Liverpool, OH 43920-4277

Phone

(330) 386-6500

Fax

(330) 386-1277

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon M Gardam Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ankle and Foot Care Centers

  • Foot & Ankle Surgery Podiatrist
  • Ravenna, OH
  • NPI 1154707818
  NPD (past)
• Ohio Sports & Spine Institute, LTD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Boardman, OH
  • NPI 1962455196
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1962430264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16844 SAINT CLAIR AVE",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439204277",
            "telephone_number": "330-386-6500",
            "fax_number": "330-386-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16844 SAINT CLAIR AVE",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439204277",
            "telephone_number": "330-386-6500",
            "fax_number": "330-386-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT10951",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "GARDAM",
            "middle_name": "M",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Billie Smith, STNA
• Emma Smith, LPC
• Georgia Smith, LPCC
• Jessica L Smith
• Jocelyn Smith, LPCC
• William Firth Smith, PHARMD
• Kathy Sodergren, LPCC/S, LSW
• Holli Sottile, M.S., CF-SLP
• Southwoods Rehabilitation LLC
• Mirjana Spahija, MD

• Physical Therapist in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.