Shannon Moreland, PTA

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

PTA.0014974 Issued in CO

Practice address

214 4TH St
Kremmling, CO 80459

Phone

(970) 724-3442

NPI assigned

Sep 14, 2021

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1023788932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 MEADOW WOOD CIR",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "804358485",
            "telephone_number": "316-992-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 4TH ST",
            "city": "KREMMLING",
            "state": "CO",
            "postal_code": "80459",
            "telephone_number": "970-724-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "SHANNON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CO",
            "license": "PTA.0014974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shannon_moreland03@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "485 Meadow Wood Cir",
            "city": "Dillon",
            "state": "CO",
            "country_code": "US",
            "postal_code": "804358485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Victoria Licha, CMT
• Kellie Logue, CRNA
• Michelle Lee Lupica, D.O.
• Stephanie Collins Miller, LCSW
• Meghan Rochelle Mont, D.O.
• Todd Odegaard
• Mark McClure Paulsen, M.D.
• Rebecca R Pearson, CCC-SLP
• Robert Craig Ratcliff, M.D.
• William Rose, MD

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Kremmling, CO
• Providers in Kremmling, CO by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.