SHANE STOVALL (RPT) – Physical Therapist, NPI 1205929064

SHANE STOVALL (RPT) is a healthcare provider. based in Ardmore, Oklahoma. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials RPT. They hold a License No. 2905 (OK). The NPI Number for SHANE STOVALL (RPT) is 1205929064

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
SHANE STOVALL (RPT)
NPI
1205929064
Phone
(580) 795-4768
Address
1405 4TH AVE NW # 296
Enumeration Date
2 October 2006
Last Update Date
22 September 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5802265566
Graduation Year
1998 (28 years ago)
PAC ID
0749320851
Group Practice PAC ID
4486794591
Professional Enrollment ID
I20100109000135
Address ID
OK734012833AR1107XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

845 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OK

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Provider Addresses for SHANE STOVALL (RPT)

  • 296, 4th Avenue Northwest, Ardmore, Carter County, Oklahoma, 73401, United States

    ARDMORE, OK 734012708

    Phone: (580) 795-4768

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100109000135IPhysical Therapist In Private PracticeOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486794591View full group profile
NameSpecialtyState
-OK
Physical Therapist In Private PracticeOK
Qualified Speech Language PathologistOK
Physical Therapist In Private PracticeOK
Occupational Therapist In Private PracticeOK
-OK
Occupational Therapist In Private PracticeOK

Reviews

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Frequently asked questions

Can I verify SHANE STOVALL (RPT) with an NPI only?
You can start verification with NPI 1205929064 for SHANE STOVALL (RPT), then check state licensing separately.
Is SHANE STOVALL (RPT) still practicing?
SHANE STOVALL (RPT) is currently listed as active in the public NPI registry.
What taxonomy line describes SHANE STOVALL (RPT)?
For research purposes, treat SHANE STOVALL (RPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect SHANE STOVALL (RPT) on a map?
Expect Ardmore, Oklahoma as a primary anchor for SHANE STOVALL (RPT) unless the record lists multiple sites.
Why does SHANE STOVALL (RPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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