IndividualActive
Shanice Pettigrew, PTA
NPI 1821643362 · Physical Therapy Assistant · Wynne, AR
Provider details
- NPI number
- 1821643362
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- Yes
- License
- PTA4462 (AR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
661 Highway 64b
Wynne, AR 72396-8506
Phone: (870) 238-7038
Street-level locationGet directions
Mailing address
9992 Highway 1 N
Colt, AR 72326-8408
Registry dates
- Enumerated
- 2019-08-01
- Last updated
- 2019-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.