Healthcare Provider Details

I. General information

NPI: 1154850998
Provider Name (Legal Business Name): SHANNON MARCELLA CHAPMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 EVANS RD
CARY NC
27513-2771
US

IV. Provider business mailing address

1855 EVANS RD
CARY NC
27513-2771
US

V. Phone/Fax

Practice location:
  • Phone: 919-694-6186
  • Fax: 919-516-0684
Mailing address:
  • Phone: 919-694-6186
  • Fax: 919-516-0684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP17180
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: