1063378073 NPI number — AMANDA TAYLOR SHELTON PT, DPT

Table of content: DR. PARAGKUMAR C PATEL M.D. (NPI 1316288517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063378073 NPI number — AMANDA TAYLOR SHELTON PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHELTON
Provider First Name:
AMANDA
Provider Middle Name:
TAYLOR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063378073
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 CAVE SPRINGS CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWENS CROSS ROADS
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35763-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
228-223-3841
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12000 TURNMEYER DR SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35803-3358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-724-5535
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PTH11709 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)