Shane W.a. Irgens, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-018218 Issued in IL

Practice address

1300 N Ashland Ave
Suite G
Chicago, IL 60622-2268

Phone

(773) 252-6227

NPI assigned

Dec 7, 2010

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

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bohannan Irgens Group LLCGroup PAC ID 2365732757, 3 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.

• Bohannan Irgens Group LLC

  • Physical Therapy Clinic/Center
  • Greenwood, AR
  • NPI 1417313925

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Greenwood Physical Therapy Center, Inc.

  • Physical Therapy Clinic/Center
  • Greenwood, AR
  • NPI 1275515959

  Physical Therapist

  NPD (past)
• MCL Therapy LLC

  • Physical Therapy Clinic/Center
  • Greenwood, AR
  • NPI 1154692481

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1679876015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N ASHLAND AVE",
            "address_2": "SUITE G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222268",
            "telephone_number": "773-252-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRGENS",
        "first_name": "SHANE",
        "middle_name": "W.A.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-018218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ireland
• Nessa Ireland
• Irene Gula DDS, PC
• Irene Silva,M.D.,S.C.
• Samia Irfani, M.D.
• Blanca Edith Iriarte Oporto, M.D.
• Sofia Iribarren Baro
• Norma S. Irie, L.C.S.W.
• Aline Irihamye, MD
• Iris Acupuncture LLC

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.