Individual provider Active NPI

Sandra Kay Shevlin, DPT

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1831372531
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8348 Issued in CO
Practice address
777 29TH St Ste 102
Boulder, CO 80303-2316
Phone
(303) 601-7495
NPI assigned
Dec 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 8348 CO Primary

Addresses

Primary practice location

777 29TH St Ste 102
Boulder, CO 80303-2316

Mailing address

777 29TH St Ste 102
Boulder, CO 80303-2316
Phone (303) 601-7495

Other practice location 1

5377 Manhattan Cir
Suite #104
Boulder, CO 80303-4333
Phone (303) 601-7495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080117000068 CO Practitioner - Physical Therapist in Private Practice 3678472834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelvic Therapy Specialists, PCGroup PAC ID 2365524345, 6 clinicians

Practice addresses (Care Compare)

4770 Baseline Rd
Suite 120
Boulder, CO 80303-2667
Phone (303) 601-7495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8348COMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelvic Therapy Specialists, PC Physical Therapist CurrentSince Jan 1, 2007 Accepting new patients

Locations

777 29th St
Ste 102
Boulder, CO 80303
Phone (303) 440-0636

4770 Baseline Rd
Ste 120
Boulder, CO 80303
Phone (303) 529-7664

5377 Manhattan Cir
Ste 104
Boulder, CO 80303
Phone (303) 601-7495

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831372531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032316",
            "telephone_number": "303-601-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 29TH ST STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032316",
            "telephone_number": "303-601-7495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5377 Manhattan Cir",
            "address_2": "Suite #104",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803034333",
            "country_code": "US",
            "telephone_number": "303-601-7495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEVLIN",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.