Coburn Shank, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

02418 Issued in IA

Practice address

1601 NW 114TH St Ste 347
Clive, IA 50325-7046

Phone

(515) 222-7350

Fax

(515) 222-7355

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coby Shank Other name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinics IncGroup PAC ID 7911810882, 441 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.

• Mercy Clinics, Inc.

  • Primary Care Clinic/Center
  • Clive, IA
  • NPI 1487670923

  IA

  Medicare reassignment Care Compare group NPD
• Mercy Clinics Inc

  • Physical Therapist
  • Clive, IA
  • NPI 1710167192
  NPD
• Mercy Clinics, Inc.

  • Obstetrics & Gynecology Physician
  • Des Moines, IA
  • NPI 1508741505
  NPD

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1558478263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674721",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674721",
            "telephone_number": "515-643-2519",
            "fax_number": "515-222-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 114TH ST STE 347",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257046",
            "telephone_number": "515-222-7350",
            "fax_number": "515-222-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANK",
        "first_name": "COBURN",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452409",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COBY",
            "last_name": "SHANK",
            "credential": "MSPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Clive, IA
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.