Shingo Tanaka, MPT
Individual provider Active NPI Physical Therapist · Rangely, CO
NPI 1003004342 · NPPES record last updated Oct 10, 2013
Key facts
- NPI
- 1003004342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10367 (CO)
- Practice address
- 225 Eagle Crest St
Rangely, CO 81648-3105 - Phone
- (970) 675-4205
- Fax
- (970) 675-4270
- NPI assigned
- Oct 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10367 | CO | MD | Physical Therapist |
| PT011869 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy and Occupational Rehabilitation Inc | Past |
Accepting new patients | |
| Rinaldi Physical Therapy | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011869 | OH | |
| Physical Therapist | 225100000X | 10367 | CO | Yes |
Addresses
Primary practice location
225 Eagle Crest St
Rangely, CO 81648-3105
Mailing address
225 Eagle Crest St
Rangely, CO 81648-3105
Phone (970) 675-4205
Other providers in Rangely, CO
- Rio Blanco County Nursing Service
- Rio Blanco County School District Re-4
- Linda Elaine Roedell
- Carla Slagle
- Charles K Sutton
- Kristen Thayn
- Jean Karyl Ting
- Jenny Tipton
- Tyson Alan Torgersen
- Valley View Hospital Association
All providers in Rangely, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.