Jennifer Lyn Shean, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3535 Issued in NC

Practice address

240 Ann St
Fayetteville, NC 28301-5543

Phone

(910) 484-7660

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962528364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NORMANDY DR",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283073479",
            "telephone_number": "845-537-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 ANN ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015543",
            "telephone_number": "910-484-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAN",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3535",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2005037324",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "006135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chavonne Nakia Shaw
• Dayco Lashell Shaw
• Shenethia Fenner Shaw, LCMHCS, NCC
• Tomeka Davis Shaw, LPC, NCC
• Dawn Shea-Frick, LCMHC, LCAS
• James E. Shearer, M.D.
• Sandra R Sheehan, DPM
• Kerstin Sheets
• Sheilas Family Home Care Agency
• Shelby Stephenson

• Physical Therapy Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.