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KEVIN SHADDOCK DPT NPI 1568940617


NPI Information

NPI: 1568940617
Provider Name: KEVIN SHADDOCK, DPT
Classification: Physical Therapist - 2251G0304X
Entity Type: Individual

Specialization: Geriatrics

Address:
816 A1A N STE 307
PONTE VEDRA, FL
ZIP 32082
Phone: (402) 190-4543
Get Directions

Kevin Shaddock, DPT is a geriatrics physical therapist in Ponte Vedra, FL. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Geriatric Physical Therapy, who has demonstrated specialized knowledge and skill in the comprehensive biopsychosocial assessment and evidence-based management of movement in aging adults. This includes, but is not limited to, specialized knowledge in and consideration of normal age-related changes and pathological manifestations across all systems; cognition and mental health; polypharmacy; fall risk mitigation; bone health; healthy and active aging, and socioeconomic and health policy issues affecting aging adults. The geriatric physical therapist is an integral part of the interdisciplinary geriatric team and serves as an advocate for the highest level of well-being for the older adult. Kevin Shaddock, DPT NPI is 1568940617. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

816 A1A N STE 307
PONTE VEDRA, FL
ZIP 32082-219
Phone: (402) 190-4543

The enumeration date for this NPI number is 7/31/2018 and was last updated on 7/31/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12251G0304XPhysical TherapistGeriatricsPT33637FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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