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

Lily Shackleford

Individual provider Physical Therapist · NPI 1801559687

Lily Shackleford is a Physical Therapist in Private Practice in San Diego, California. Qualified in 2021, 5 years ago. Practices with Foothills Physical Therapy PA, a 27-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

10405 San Diego Mission Rd # 102104
San Diego, CA 92108-2102
Phone: (619) 369-9442
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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 300618 (CA)

Record details

NPI number1801559687
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 18, 2021
Last updated in NPPESAugust 28, 2025
Certification dateAugust 28, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Foothills Physical Therapy Pa — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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