Active NPI
Shaina Eileen Ettinger, P.T.
- Physical Therapist
- Sun City, AZ
National Provider Identifier
1982619656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5390
- Practice address
- 13203 N 103Rd Ave
Sun City, AZ 85351-3028 - Phone
- (866) 933-4248
- Fax
- (623) 933-7049
- NPI assigned
- Jul 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5390 | AZ | Primary |
Addresses
Primary practice location
13203 N 103Rd Ave
Sun City, AZ 85351-3028
Mailing address
PO Box 3497
Sturtevant, WI 53177-0300
Phone (877) 552-2996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5390 | AZ | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dorland Physical Therapy and Rehab Specialists | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Sun City West, AZ
- NPI 1093728644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1982619656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3497",
"city": "STURTEVANT",
"state": "WI",
"postal_code": "531770300",
"telephone_number": "877-552-2996",
"fax_number": "866-245-8064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13203 N 103RD AVE",
"city": "SUN CITY",
"state": "AZ",
"postal_code": "853513028",
"telephone_number": "866-933-4248",
"fax_number": "623-933-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETTINGER",
"first_name": "SHAINA",
"middle_name": "EILEEN",
"name_prefix": "Miss",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-30",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "5390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.