Shannon Alexandria Reeder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA18095 Issued in FL

Practice address

1155 Malabar Rd NE
Suite 13
Palm Bay, FL 32907-3245

Phone

(321) 409-5777

Fax

(321) 409-5888

NPI assigned

Aug 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1992999254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MALABAR RD NE",
            "address_2": "SUITE 13",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329073245",
            "telephone_number": "321-409-5777",
            "fax_number": "321-409-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MALABAR RD NE",
            "address_2": "SUITE 13",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329073245",
            "telephone_number": "321-409-5777",
            "fax_number": "321-409-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "SHANNON",
        "middle_name": "ALEXANDRIA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Subhash G Rege, M.D.S
• Regis Manor LLC

• Physical Therapy Assistant in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.