Shane Omer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

194449 Issued in AK

Practice address

304 W Evergreen Ave Ste 101
Palmer, AK 99645-6970

Phone

(907) 745-8686

NPI assigned

May 12, 2021

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

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

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 and National Provider Directory roles.

• Select Physical Therapy Holdings Inc

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

  Physical Therapist

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

  • Physical Therapy Clinic/Center
  • Sterling, AK
  • NPI 1548890569
  NPD
• Select Physical Therapy Holdings Inc

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

  • Physical Therapy Clinic/Center
  • Fairbanks, AK
  • NPI 1619946530
  NPD (past)

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1487238721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 GOLD KEY LN",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456178",
            "telephone_number": "907-350-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W EVERGREEN AVE STE 101",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456970",
            "telephone_number": "907-745-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMER",
        "first_name": "SHANE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-12",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "194449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drue S Olson
• Karalei Olson
• Laurelei M Olson
• Mary Eicher Olson, PT
• Sabrina Olson
• Optimum Performance Chiropractic, Inc.
• Gena Ruth Ornquist, LPC
• Benjamin Mark Osburn, PHARMD
• Serena Grijalva Outhier
• Lilyan Overland

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.