MEDICARE: ERICA SHEAVES PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305213037	VA

General Provider Information

NPI Number	:	1811557853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA SHEAVES PT, DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	729 RICHMOND AVE STE A
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-4981
Country	:	US
Telephone Number	:	540-569-2390
Fax Number	:	540-569-2085

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	02/27/2020

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