Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jason Shallow, MPT

Individual provider Physical Therapist · NPI 1396096327

Jason Shallow, MPT is a Physical Therapist in Private Practice in Chesterfield, Michigan. Qualified in 1999, 27 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
27
Licensed in
MI
In the registry since
2012
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

50912 Gratiot Ave
Chesterfield, MI 48051-3134
Phone: (586) 200-6603
Fax: (586) 200-6604
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501010038 (MI)

Record details

NPI number1396096327
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT
Sole proprietorNo
NPI enumeratedOctober 1, 2012
Last updated in NPPESApril 6, 2018
Mailing address600 Oakmont Ln Ste 600c, Westmont, IL 60559-5548

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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