Healthcare Provider Details

I. General information

NPI: 1396368395
Provider Name (Legal Business Name): PHILANTHROPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 FRAZIER CT STE 2C
GEORGETOWN KY
40324-9026
US

IV. Provider business mailing address

107 FRAZIER CT
GEORGETOWN KY
40324-8973
US

V. Phone/Fax

Practice location:
  • Phone: 859-559-7576
  • Fax:
Mailing address:
  • Phone: 859-559-7576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RYAN SHELTON
Title or Position: OWNER
Credential: DPT
Phone: 859-559-7576