Shelby Nicole Blum, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2640 Issued in AK

Practice address

1700 E Bogard Rd
Wasilla, AK 99654-6563

Phone

(907) 376-4325

NPI assigned

Aug 9, 2013

Last updated

May 19, 2016By the provider in NPPES

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

Other names 1

• Shelby Nicole Johnson Former name

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Eagle River, AK
  • NPI 1699743484

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Select Physical Therapy Holdings, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Soldotna, AK
  • NPI 1649943184
  NPD
• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1295168581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 N INDIAN HILL CIR",
            "address_2": "APT C",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996545775",
            "telephone_number": "612-803-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546563",
            "telephone_number": "907-376-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "SHELBY",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "JOHNSON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard W. Blake, PA-C
• Emily Elizabeth Blakeslee
• Meranda Blanchard, L.M.T.
• Rhonda Blanton
• Alexia Blas-Alcantara
• Kimber Blythe
• Iuliana Dit Bobanga, M.D.
• Mary Bobby
• Daniel Bocher
• Elizabeth Claret Bochynski, RN

• Physical Therapist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.