Individual provider Active NPI

Joshua Tanner Shelby, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1982298246
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1342301 Issued in TX
Practice address
1901 Cooper St
Fort Worth, TX 76104-2546
Phone
(817) 877-8977
Fax
(817) 877-1106
NPI assigned
Feb 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1342301 TX Primary

Addresses

Primary practice location

1901 Cooper St
Fort Worth, TX 76104-2546

Mailing address

1901 Cooper St
Fort Worth, TX 76104-2546
Phone (817) 877-8977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310002173 TX Practitioner - Physical Therapist in Private Practice 8527474865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Rehabilitation Specialists, IncGroup PAC ID 1759337744, 3 clinicians

Practice addresses (Care Compare)

1901 Cooper St
Fort Worth, TX 76104-2546
Phone (817) 877-8977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1342301TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Rehabilitation Specialists, Inc CurrentSince Apr 8, 2024 Accepting new patients
Coppell Spine & Sports Rehab Limited Partnership Past Accepting new patients

Locations

1901 Cooper St
Ft Worth, TX 76104
Phone (817) 877-8977

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1982298246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042546",
            "telephone_number": "817-877-8977",
            "fax_number": "817-877-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042546",
            "telephone_number": "817-877-8977",
            "fax_number": "817-877-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "JOSHUA",
        "middle_name": "TANNER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1342301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.