Shannon Marie Irish, PT

Individual provider Active NPI Physical Therapist · Avon, CO

NPI 1083993166 · NPPES record last updated Jun 11, 2026

Key facts

NPI
1083993166
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
7586 (CO)
Practice address
142 E Beaver Creek Blvd Unit 109
Avon, CO 81620-4800
Phone
(970) 790-9600
Fax
(970) 790-9601
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axis Sports Medicine LLC (18 clinicians)

Practice addresses (Care Compare)

142 Beaver Creek Place
Unit 109
Avon, CO 81620
Phone (970) 790-9600

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040309000649 CO Practitioner - Physical Therapist in Private Practice 5991693178 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7586 CO Yes

Addresses

Primary practice location

142 E Beaver Creek Blvd Unit 109
Avon, CO 81620-4800

Mailing address

PO Box 5584
Frisco, CO 80443-5584
Phone (970) 368-6054

Other providers in Avon, CO

All providers in Avon, CO · Physical Therapist in Colorado

Sources for this page

Verify at the official NPI Registry.