Shannon Megan Bulmer, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15149 Issued in CO

Practice address

9320 Grand Cordera Pkwy Ste 125
Colorado Springs, CO 80924-7011

Phone

(719) 535-2757

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon Megan Massine Former name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Physical Therapy LLCGroup PAC ID 2264487214, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Proactive Physical Therapy LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1063454874

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Proactive Physical Therapy LLC

  • Physical Therapist
  • Monument, CO
  • NPI 1326655101

  Single Specialty

  NPD

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1093232829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 GRAND CORDERA PKWY STE 125",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 GRAND CORDERA PKWY STE 125",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247011",
            "telephone_number": "719-535-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULMER",
        "first_name": "SHANNON",
        "middle_name": "MEGAN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "15149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MASSINE",
            "middle_name": "MEGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Bullington
• Erin Allen Bullock, APN, FNP-BC
• John W Bullock, PA-C
• Lynn Bullock, MD
• Monica Taylor Bullock, DO
• Clarence Keon Bumpas
• Chelsea Bunch, MSW
• Sarah Bunch
• Brenda J Bundrick, LPCC
• Bundukamara Inc

• Physical Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.