Brian Shoulders, DPT

Individual provider Active NPI Physical Therapist · Fairbanks, AK

NPI 1124844170 · NPPES record last updated Sep 10, 2025

Key facts

NPI
1124844170
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501303618 (MI)
Practice address
3745 Geist Rd
Fairbanks, AK 99709-3554
Phone
(907) 931-5223
NPI assigned
Nov 25, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Therapy LLC (170 clinicians)
Adient Alaska LLC (16 clinicians)

Practice addresses (Care Compare)

310 Duran Dr
Shelbyville, IN 46176-1986
Phone (317) 421-0244

3745 Geist Rd
Fairbanks, AK 99709-3554
Phone (907) 456-1112

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AK, IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251104004401 AK Practitioner - Physical Therapist in Private Practice 9335639715 Reassigns benefits to 1 organization
I20260507002719 IN Practitioner - Physical Therapist in Private Practice 9335639715 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5501303618MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adient Alaska, LLC Physical Therapist Current
since Sep 22, 2025
Accepting new patients
R & F Inc. Physical Therapist Past Accepting new patients

Locations

3745 Geist Rd
Fairbanks, AK 99709
Phone (907) 456-1112

1919 Lathrop St
Ste 123
Fairbanks, AK 99701
Phone (907) 290-3075

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501303618 MI Yes

Addresses

Primary practice location

3745 Geist Rd
Fairbanks, AK 99709-3554

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 307-8206

Other practice location 1

902 Industrial Dr
Tecumseh, MI 49286-9701
Phone (517) 423-7722

Other practice location 2

1525 W Maumee St
Adrian, MI 49221-1899
Phone (517) 265-6007

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 10, 2025.

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1124844170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-307-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 GEIST RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093554",
            "telephone_number": "907-931-5223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Tecumseh",
            "state": "MI",
            "postal_code": "492869701",
            "country_code": "US",
            "telephone_number": "517-423-7722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1525 W Maumee St",
            "address_purpose": "LOCATION",
            "city": "Adrian",
            "state": "MI",
            "postal_code": "492211899",
            "country_code": "US",
            "telephone_number": "517-265-6007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "BRIAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

All providers in Fairbanks, AK · Physical Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.