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

Kevin Shaddock, DPT

Individual provider Geriatric Physical Therapist · NPI 1568940617

Kevin Shaddock, DPT is a Geriatric Physical Therapist in Ponte Vedra, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2018
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

816 A1A N Ste 307
Ponte Vedra, FL 32082-3219
Phone: (402) 190-4543
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Physical Therapist (primary) Taxonomy 2251G0304X · Licence PT33637 (FL)

Record details

NPI number1568940617
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedJuly 31, 2018
Last updated in NPPESJuly 31, 2018
Mailing address3901 University Blvd S, Jacksonville, FL 32216-4312

Other providers in Ponte Vedra