Shane R Burgess, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0017979 Issued in CO

Practice address

1650 Cochrane Cir BLDG 7505
Fort Carson, CO 80913-4604

Phone

(719) 526-5231

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

• Panorama Orthopedics & Spine Center, PC

  • Physical Therapy Clinic/Center
  • Colorado Springs, CO
  • NPI 1194390518
  NPD
• Panorama Orthopedics and Spine Center PC

  • Orthopaedic Surgery Physician
  • Golden, CO
  • NPI 1295787950
  NPD
• Panorama Orthopedics and Spine Center PC

  • Physical Therapy Clinic/Center
  • Denver, CO
  • NPI 1467052258
  NPD
• Rancho Physical Therapy, Inc.

  • Physical Therapist
  • Corona, CA
  • NPI 1891763561
  NPD (past)

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1891209706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR BLDG 7505",
            "address_2": "CREDENTIAL OFFICE RM #163",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-5231",
            "fax_number": "719-526-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR BLDG 7505",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-5231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10020 Indiana Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925035479",
            "country_code": "US",
            "telephone_number": "951-637-2320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11276 5th St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917300923",
            "country_code": "US",
            "telephone_number": "909-481-0437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6850 Brockton Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925063815",
            "country_code": "US",
            "telephone_number": "951-534-0600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31764 Casino Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925304571",
            "country_code": "US",
            "telephone_number": "951-471-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "886 Magnolia Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928793105",
            "country_code": "US",
            "telephone_number": "951-340-3402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1695 S San Jacinto Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "San Jacinto",
            "state": "CA",
            "postal_code": "925835103",
            "country_code": "US",
            "telephone_number": "951-665-1510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650 Cochrane Cir Bldg 7505",
            "address_purpose": "LOCATION",
            "city": "Fort Carson",
            "state": "CO",
            "postal_code": "809134613",
            "country_code": "US",
            "telephone_number": "719-526-5231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23100 Eucalyptus Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925535439",
            "country_code": "US",
            "telephone_number": "951-485-4594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11276 5th St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917300923",
            "country_code": "US",
            "telephone_number": "909-481-0434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "SHANE",
        "middle_name": "R",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT293973",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0017979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Buchanan, FNP
• Emily Christine Buck, MD
• Ryan Bucknam, M.D.
• Katherine Buechner
• Lily Dandy Bultema, CNM
• Matthew Joseph Burke, MD, PHD
• John Butera, RMT PTA
• Mercedes Marie Butitta, CNM
• Deepthi Venkat Byreddy, M.D.
• Jennifer Ruth Cable, LCSW

• All providers in Fort Carson, CO
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.