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

Shane Davis, PT

Individual provider Physical Therapist · NPI 1033170725

Shane Davis, PT is a Physical Therapist in Private Practice in Boonville, New York. Qualified in 1997, 29 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
29
Licensed in
NY
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

13040 State Route 12
Boonville, NY 13309-4942
Phone: (315) 358-4028
Fax: (315) 358-4394
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 022935 (NY)

Record details

NPI number1033170725
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedMarch 31, 2006
Last updated in NPPESJune 27, 2025
Certification dateJune 27, 2025
Mailing address13040 State Route 12, Boonville, NY 13309-4942

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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