NPIMap

Organization Active NPI

Shannondell Inc.

Doing business as Rehab at Shannondell

  • Physical Therapy Clinic/Center
  • Audubon, PA
National Provider Identifier
1972982247
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SHANNONDELL INC.
Doing business as
Rehab at Shannondell
Practice address
10000 Shannondell Dr
Audubon, PA 19403-5615
Phone
(610) 728-5236
NPI assigned
May 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Mr. Daniel E Freed
Title
VP of Health Services
Phone
(610) 728-5400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

10000 Shannondell Dr
Audubon, PA 19403-5615

Mailing address

10000 Shannondell Dr
Audubon, PA 19403-5615

Other names 1

  • Rehab at Shannondell Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130627000670 PA Part B Supplier - Clinic/Group Practice 9032141189 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Audubon, PA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Shannondell Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1972982247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SHANNONDELL DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194035615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SHANNONDELL DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194035615",
            "telephone_number": "610-728-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNONDELL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "FREED",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP OF HEALTH SERVICES",
        "authorized_official_telephone_number": "610-728-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab at Shannondell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Audubon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.