Mandi Beth Shultz, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

RN00144317 Issued in WA

Practice address

123 S Kent St
Kennewick, WA 99336-5020

Phone

(509) 222-5103

Fax

(509) 222-5101

NPI assigned

Sep 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21625/brand/2/csg/1/fhir/r4

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.

• Balancing Act Physical Therapy PLLC

  dba Balancing Act Physical Therapy

  • Physical Therapy Clinic/Center
  • Kennewick, WA
  • NPI 1982946950
  NPD

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1235851254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W 30TH AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993372887",
            "telephone_number": "509-302-5313",
            "fax_number": "509-582-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S KENT ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365020",
            "telephone_number": "509-222-5103",
            "fax_number": "509-222-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "MANDI",
        "middle_name": "BETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "RN00144317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shopko Stores Operating Co LLC (ShopKo Pharmacy 092)
• Shopko Stores Operating Co. LLC (ShopKo Optical 092)
• William L Short
• Dakota Showalter
• Toneyell Sherell Shropshire, PT, DPT
• Terry Kelly Shultz, P.T.
• Oliver Noah Journey Ro Siah
• Glenn Siekawitch
• Peter K Sien, MD
• Lilliam A Sierra, M.D.

• School Registered Nurse in Kennewick, WA
• Providers in Kennewick, WA by specialty
• School Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.