Individual provider Active NPI

Sharlane Vera-Vadell, PT

  • Physical Therapist
  • Brandon, FL
National Provider Identifier
1992808174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22096 Issued in FL
Practice address
116 E Bloomingdale Avenue
Brandon, FL 33511-8101
Phone
(813) 655-3342
Fax
(813) 653-0894
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT22096 FL Primary

Addresses

Primary practice location

116 E Bloomingdale Avenue
Brandon, FL 33511-8101

Mailing address

116 E Bloomingdale Avenue
Brandon, FL 33511-8101
Phone (813) 655-3342

Other identifiers 2

IdentifierTypeStateIssuer
P00299258OtherRAILROAD RETIREMENT
Y908VOtherFLBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
PT22096FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sullivan Rehab Inc Physical Therapist PastSince Dec 6, 2009 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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992808174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E BLOOMINGDALE AVENUE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118101",
            "telephone_number": "813-655-3342",
            "fax_number": "813-653-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E BLOOMINGDALE AVENUE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118101",
            "telephone_number": "813-655-3342",
            "fax_number": "813-653-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA-VADELL",
        "first_name": "SHARLANE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "P00299258",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y908V",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.