Shane Michael Osgood, ATC, CEAS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT-509 Issued in ID

Practice address

833 Shoshone St N
Twin Falls, ID 83301-6370

Phone

(607) 377-7850

NPI assigned

Dec 31, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1144466889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2126",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833032126",
            "telephone_number": "607-377-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SHOSHONE ST N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016370",
            "telephone_number": "607-377-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSGOOD",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "ATC, CEAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-31",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-509",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002043-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesus Ortega, CADC
• Orthopro of Twin Falls, Inc
• Adan Ortiz, PHARMD
• Shelly Marie Osborne, LCPC
• Melissa Dawn Osen, LCSW
• Joseph Eldon Ostler, M.D., PH.D.
• Paul G. Ostyn, MPT, MA
• Amanda Lynn Overacre, LCSW
• Amanda May Ovitt, OT
• Shannon Marie Owen, RN

• Athletic Trainer in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Athletic Trainer in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.