Shaun C Scissom

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTP-PT-LIC-27322 Issued in MT

Practice address

1 Bobcat Circle
Bozeman, MT 59715

Phone

(406) 414-5000

NPI assigned

Feb 20, 2019

Last updated

Apr 9, 2025By the provider in NPPES

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 MT

Enrollment records 1

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.

• Bozeman Health Deaconess Hospital

  • Family Medicine Physician
  • Bozeman, MT
  • NPI 1619347390

  Physical Therapist

  Medicare reassignment NPD
• Bozeman Health Deaconess Hospital

  • Durable Medical Equipment & Medical Supplies
  • Bozeman, MT
  • NPI 1013733955
  NPD
• Bozeman Health Deaconess Hospital

  • Emergency Medicine Physician
  • Bozeman, MT
  • NPI 1437529112
  NPD

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1750848214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOBCAT CIRCLE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-414-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCISSOM",
        "first_name": "SHAUN",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212609",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-27322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Thomas Gallagher Schwem, MAC
• Frederick Joseph Schwendeman, DMD
• Kristina Schwertz
• Danielle Claire Schwieterman, D.D.S.
• Nikole Sciortino, LCSW
• SCL Health Medical Group - Billings, LLC (Intermountain Health Bozeman Clinic - Family Medicine)
• Scott E. Lawson DDS
• Eric Scranton, PA-C
• Nicholia Seaholm, RN
• Amy Seaman, OTR/L

• Physical Therapist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.