LILY SHACKLEFORD
NPI 1801559687
Physical Therapist in San Diego, CA

Active since October 18, 2021Accepts Medicare Assignment
10405 SAN DIEGO MISSION RD # 102104, SAN DIEGO, CA 92108(619) 369-9442 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 13, 2021, Oct 18, 2021 (2 updates tracked since 2021).

About Lily Shackleford NPPES

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

LILY SHACKLEFORD (NPI 1801559687) is an individual physical therapist in San Diego, California, licensed in California (300618) and active in the NPI registry since October 2021. She is a graduate of Other (2021).

NPPES Registry Identity

NPI1801559687
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameLILY SHACKLEFORD
Location Address10405 SAN DIEGO MISSION RD # 102104San Diego, CA 92108-2102
Mailing Address10405 San Diego Mission Rd # 102104San Diego, CA 92108-2102
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 18, 2021
Last NPPES UpdateAugust 28, 20252 updates tracked since enumeration
NPPES CertifiedAugust 28, 2025
NPI 1801559687 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 CA · 300618
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:<ul><li>Diagnose and manage movement dysfunction and enhance physical and functional abilities.</li><li>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.</li><li>Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.</li><li>Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.</li><li>Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.</li></ul>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.

10405 SAN DIEGO MISSION RD # 102104, San Diego, CA 92108

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Lily Shackleford is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820460678
PECOS Enrollment IDI20240418003804

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112
This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
448 services27 patients
Therapy procedure using functional activities 97530
A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
79 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Lily Shackleford's NPI number?

The NPI number for Lily Shackleford is 1801559687. It was assigned to this individual provider in the NPPES registry on October 18, 2021.

Where is Lily Shackleford located?

Lily Shackleford practices at 10405 San Diego Mission Rd # 102104, San Diego, CA 92108. The listed phone number is (619) 369-9442.

What is Lily Shackleford's specialty?

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

Is Lily Shackleford enrolled in Medicare?

Yes. Lily Shackleford is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lily Shackleford accept?

Health plans from Providence Health Plan list Lily Shackleford as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lily Shackleford was last updated on August 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.