Shannon Dale Snider, P. T., CSCS
Individual provider Active NPI Physical Therapist · Pewee Valley, KY
NPI 1992818785 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992818785
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 003490 (KY)
- Practice address
- 309 La Grange Rd
Pewee Valley, KY 40056-9168 - Phone
- (502) 243-6868
- Fax
- (502) 243-6867
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
309 La Grange Rd
Pewee Valley, KY 40056-9168
Phone (502) 243-6868
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040317000656 | KY | Practitioner - Physical Therapist in Private Practice | 6709776420 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003490 | KY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oldham County Physical Therapy, Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
309 La Grange Rd
Pewee Valley, KY 40056
Phone (502) 243-6868
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003490 | KY | Yes |
Addresses
Primary practice location
309 La Grange Rd
Pewee Valley, KY 40056-9168
Mailing address
PO Box 615
309 Lagrange Rd.
Pewee Valley, KY 40056-0615
Phone (502) 243-6868
Other providers in Pewee Valley, KY
- Vijayalakshmi Kasunganti Rao
- Rural Educational Association of Kentucky
- Sara Carey, LLC
- Sandra Schulz
- Karen Elizabeth Snider
- Andrea Sorsa
- Steven C Applegate PSC
- The Hearing Shoppe LLC
- Vein Aesthetics MD PLLC
- Wild Orchid Counseling
All providers in Pewee Valley, KY · Physical Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.