SHAWN BLACK PT
NPI 1639386030
Physical Therapist in Florence, KY

Active since May 16, 2007
2628 LEGACY RDG, FLORENCE, KY 41042(859) 512-7826 Get Directions Write a Review

NPPES record last updated: October 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shawn Black Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAWN BLACK PT (NPI 1639386030) is an individual physical therapist in Florence, Kentucky, licensed in Kentucky (003292) and active in the NPI registry since May 2007. He is a graduate of Other (1997).

NPPES Registry Identity

NPI1639386030
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameSHAWN BLACKCredential: PT
Location Address2628 LEGACY RDGFlorence, KY 41042-8403
Mailing Address2628 Legacy RdgFlorence, KY 41042-8403 · (859) 512-7826
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateMay 16, 2007
Last NPPES UpdateOctober 9, 2025
NPPES CertifiedOctober 9, 2025
✔ NPI 1639386030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in KY · 003292
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
2628 LEGACY RDG, Florence, KY 41042

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shawn Black Pt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325091440
PECOS Enrollment IDI20251111001624

Medicare Billing Reassignments

2

Medicare enrollment records show Shawn Black reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Physical Therapist
8520 GUNPOWDER RD
Florence, KY 41042
  • Reassigned Medicare billing, Kentucky enrollment
  • 4 clinicians in this Medicare group
Physical Therapist
524 S CRESCENT DR
Kirkwood, MO 63122
  • Reassigned Medicare billing, Kentucky enrollment
  • 10 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawn Black's NPI number?

The NPI number for Shawn Black is 1639386030. It was assigned to this individual provider in the NPPES registry on May 16, 2007.

Where is Shawn Black located?

Shawn Black practices at 2628 Legacy Rdg, Florence, KY 41042. The listed phone number is (859) 512-7826.

What is Shawn Black's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Shawn Black enrolled in Medicare?

Yes. Shawn Black is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shawn Black's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shawn Black reassigns Medicare benefits to 2 organizations: Legacy Therapy And Rehab Tri-State LLC (Florence, KY) and Smart Rehab, LLC (Kirkwood, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shawn Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shawn Black was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.