David Shank
Individual provider Active NPI Orthopedic Physical Therapist · Redfield, KS
NPI 1124557772 · NPPES record last updated Jun 7, 2017
Key facts
- NPI
- 1124557772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 11-05632 (KS)
- Practice address
- 1675 125TH St
Redfield, KS 66769-9529 - Phone
- (162) 021-5530
- NPI assigned
- Jun 7, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 11-05632 | KS | MD | Orthopedic Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 11-05632 | KS | Yes |
Addresses
Primary practice location
1675 125TH St
Redfield, KS 66769-9529
Mailing address
11808 Grant St FL 100
Omaha, NE 68164-3616
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2017. 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.