Shannon Moreland, PTA
Individual provider Active NPI Sports Medicine (Neuromusculoskeletal Medicine) Physician · Kremmling, CO
NPI 1023788932 · NPPES record last updated Sep 14, 2021
Key facts
- NPI
- 1023788932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X
- License
- PTA.0014974 (CO)
- Practice address
- 214 4TH St
Kremmling, CO 80459 - Phone
- (970) 724-3442
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA.0014974 | CO | MD | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | PTA.0014974 | CO | Yes |
Addresses
Primary practice location
214 4TH St
Kremmling, CO 80459
Mailing address
485 Meadow Wood Cir
Dillon, CO 80435-8485
Phone (316) 992-2505
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104357707 | Other | CO | EMPLOYER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | shannon_moreland03@hotmail.com | Direct |
Other providers in Kremmling, CO
- Michelle Victoria Licha
- Kellie Logue
- Michelle Lee Lupica
- Stephanie Collins Miller
- Meghan Rochelle Mont
- Todd Odegaard
- Mark McClure Paulsen
- Rebecca R Pearson
- Robert Craig Ratcliff
- William Rose
All providers in Kremmling, CO · Sports Medicine (Neuromusculoskeletal Medicine) Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2021. 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.