Shontol Burkhalter, DPT
Individual provider Active NPI Physical Therapist · Blanding, UT
NPI 1013349935 · NPPES record last updated Aug 1, 2013
Key facts
- NPI
- 1013349935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 8673165-8016 (UT)
- Practice address
- 802 S 200 W
Blanding, UT 84511-3910 - Phone
- (435) 678-3869
- Fax
- (435) 678-3769
- NPI assigned
- Aug 1, 2013
- Sex
- Female
- 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 |
|---|---|---|---|
| 8673165-8016 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Navajo Health System, Incorporated | Past | Accepting new patients | |
| Utah Navajo Health System, Incorporated | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8673165-8016 | UT | Yes |
Addresses
Primary practice location
802 S 200 W
Blanding, UT 84511-3910
Mailing address
PO Box 745
Blanding, UT 84511-0745
Phone (435) 678-3869
Other providers in Blanding, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 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.