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

Individual provider Physical Therapist · NPI 1558380659

Shaon D Fry, PT is a Physical Therapist in Private Practice in Columbia, Missouri. Qualified in 1995, 31 years ago. Practices with Boone Physician Services LLC, a 240-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
31
Licensed in
MO
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

202 E Nifong Blvd Ste A
Columbia, MO 65203-3759
Phone: (573) 777-6955
Fax: (573) 777-6957
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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 109173 (MO)

Record details

NPI number1558380659
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 19, 2006
Last updated in NPPESMarch 18, 2015

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Boone Physician Services Llc — 240 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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