Individual provider Active NPI

Shannon Burke Colleton, DPT

  • Physical Therapist
  • Newark, DE
National Provider Identifier
1992374144
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0014387 Issued in DE
Practice address
540 S College Ave Ste 160
Newark, DE 19713-1302
Phone
(302) 831-8893
Fax
(302) 831-4468
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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 J1-0014387 DE Primary

Addresses

Primary practice location

540 S College Ave Ste 160
Newark, DE 19713-1302

Mailing address

540 S College Ave Ste 160
Newark, DE 19713-1302
Phone (302) 831-8893

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
J1-0014387DEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1992374144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 S COLLEGE AVE STE 160",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131302",
            "telephone_number": "302-831-8893",
            "fax_number": "302-831-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S COLLEGE AVE STE 160",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131302",
            "telephone_number": "302-831-8893",
            "fax_number": "302-831-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETON",
        "first_name": "SHANNON",
        "middle_name": "BURKE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0014387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.