NPIMap

Organization Active NPI

Shippensburg Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Shippensburg, PA
National Provider Identifier
1972671352
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017913 Issued in PA
Legal business name
SHIPPENSBURG PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Practice address
20 Park PL
Suite 2
Shippensburg, PA 17257-9806
Phone
(717) 477-8030
Fax
(717) 477-8040
NPI assigned
Dec 1, 2006
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Dr. Thomas Edward Blount, DPTNPI 1215954227
Title
President
Phone
(717) 477-8030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017913 PA Primary

Addresses

Primary practice location

20 Park PL
Suite 2
Shippensburg, PA 17257-9806

Mailing address

20 Park PL
Suite 2
Shippensburg, PA 17257-9806
Phone (717) 477-8030

Other identifiers 1

IdentifierTypeStateIssuer
1023274600001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070430000384 PA Part B Supplier - Clinic/Group Practice 2860598364 Receives reassigned benefits from 19 practitioners
Practice locations: Gettysburg, PA; Greencastle, PA; Newville, PA; Shippensburg, PA; Waynesboro, PA

National Provider Directory

National Provider Directory

Locations

1007 Wayne Ave
Chambersburg, PA 17201
Phone (717) 263-5147

371 E Water St
Ste 1
Gettysburg, PA 17325
Phone (717) 549-2945

145 E Baltimore St
Ste 2
Greencastle, PA 17225
Phone (717) 643-1813

91 S High St
#3
Newville, PA 17241
Phone (717) 477-8030

2 Beistle Plz
Shippensburg, PA 17257
Phone (717) 477-8030

20 Park Pl
#2
Shippensburg, PA 17257
Phone (717) 477-8030

118 Walnut St
Ste 114
Waynesboro, PA 17268
Phone (717) 559-0559

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1972671352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PARK PL",
            "address_2": "SUITE 2",
            "city": "SHIPPENSBURG",
            "state": "PA",
            "postal_code": "172579806",
            "telephone_number": "717-477-8030",
            "fax_number": "717-477-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PARK PL",
            "address_2": "SUITE 2",
            "city": "SHIPPENSBURG",
            "state": "PA",
            "postal_code": "172579806",
            "telephone_number": "717-477-8030",
            "fax_number": "717-477-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIPPENSBURG PHYSICAL THERAPY AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "BLOUNT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-477-8030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023274600001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shippensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.