| Kevin Shaddock, DPT | |
|
816 A1a N Ste 307, Ponte Vedra, FL 32082-3219 | |
| (402) 190-4543 | |
| Not Available |
| Full Name | Kevin Shaddock |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist - Geriatrics |
| Location | 816 A1a N Ste 307, Ponte Vedra, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568940617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251G0304X | Physical Therapist - Geriatrics | PT33637 (Florida) | Primary |
| Provider Name | Progress Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1164851085 PECOS PAC ID: 1951530849 Enrollment ID: O20140219001344 |
| Provider Name | Orthopedic And Sports Physical Therapy Services Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1588661235 PECOS PAC ID: 4082507660 Enrollment ID: O20150508000371 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Shaddock, DPT 3901 University Blvd S, Jacksonville, FL 32216-4312 Ph: (904) 345-7336 | Kevin Shaddock, DPT 816 A1a N Ste 307, Ponte Vedra, FL 32082-3219 Ph: (402) 190-4543 |
Aegis Group Practice, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 999 Crosswater Pkwy, Ponte Vedra, FL 32081 Phone: 800-444-6845 Fax: 844-640-6066 | |
Prevail Therapy Services, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 22 Bermuda Greens Ave, Ponte Vedra, FL 32081 Phone: 904-208-8811 Fax: 904-814-8953 | |
Valerie J Spees, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 203 Fort Wade Rd Unit 130, Ponte Vedra, FL 32081 Phone: 904-686-3111 Fax: 904-686-3140 | |
Karissa Rowland, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 Colonnade Dr Ste 100, Ponte Vedra, FL 32081 Phone: 904-395-1755 | |
Mrs. Tori S Miller, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 22 Bermuda Greens Ave, Ponte Vedra, FL 32081 Phone: 904-208-8758 | |
Elyse Mackenzie Warren, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 232 Ponte Vedra Park Dr, Ponte Vedra, FL 32082 Phone: 904-634-0640 Fax: 904-634-0203 | |
Zachary Engel, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 465 Town Plaza Ave # B, Ponte Vedra, FL 32081 Phone: 904-222-3780 |