Individual provider Active NPI

Shawn Glenn Moehring, MPT, DIP. MDT, OCS

  • Physical Therapist
  • Post Falls, ID
National Provider Identifier
1619102621
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1075 Issued in ID
Practice address
640 N Thornton St
Post Falls, ID 83854-7495
Phone
(208) 773-2888
Fax
(208) 806-0222
NPI assigned
May 19, 2009
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-1075 ID Primary

Addresses

Primary practice location

640 N Thornton St
Post Falls, ID 83854-7495

Mailing address

640 N Thornton St
Post Falls, ID 83854-7495
Phone (208) 773-2888

Other practice location 1

940 W Ironwood Dr Ste A
Coeur D Alene, ID 83814-2486
Phone (208) 625-5311

Other identifiers 1

IdentifierTypeStateIssuer
PT-1075OtherIDPHYSICAL THERAPY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090612000203 ID Practitioner - Physical Therapist in Private Practice 3779633730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mac Physical Therapy, PLLCGroup PAC ID 3779899083, 6 clinicians

Practice addresses (Care Compare)

640 N Thornton St
Post Falls, ID 83854-7495
Phone (208) 773-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-1075IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mac Physical Therapy, PLLC CurrentSince Jun 25, 2015 Accepting new patients
Pinnacle Physical Therapy and Sports Medicine, Inc Physical Therapist PastSince Apr 1, 2007 Accepting new patients

Locations

940 W Ironwood Dr
Ste C
Coeur D Alene, ID 83814
Phone (208) 773-2888

95 W Centa Ave
Hayden, ID 83835

95 W Centa Ave
Ste 201
Hayden, ID 83835
Phone (208) 773-2888

640 N Thornton St
Post Falls, ID 83854
Phone (208) 262-8166

927 E Polston Ave
Ste 201
Post Falls, ID 83854
Phone (208) 771-2939

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1619102621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N THORNTON ST",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838547495",
            "telephone_number": "208-773-2888",
            "fax_number": "208-806-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N THORNTON ST",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838547495",
            "telephone_number": "208-773-2888",
            "fax_number": "208-806-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 W Ironwood Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142486",
            "country_code": "US",
            "telephone_number": "208-625-5311",
            "fax_number": "208-625-4184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOEHRING",
        "first_name": "SHAWN",
        "middle_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "MPT, DIP. MDT, OCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT-1075",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.