Shanna Marie Herman, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-4287 Issued in ID

Practice address

405 W Myrtle St
Boise, ID 83702-7658

Phone

(208) 385-3420

Fax

(208) 385-3421

NPI assigned

Nov 10, 2015

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1902279136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W MYRTLE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027658",
            "telephone_number": "208-385-3420",
            "fax_number": "208-385-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W MYRTLE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027658",
            "telephone_number": "208-385-3420",
            "fax_number": "208-385-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "SHANNA",
        "middle_name": "MARIE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-4287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Scott Herd, M.D.
• Chennai Marie Hererra, L.M.T.
• Brooke C Hergert, MD
• Heritage Imaging, Inc.
• Brookelyn Herman
• Prisca Hermene
• Camille Hermosillo
• Angela Maria Hernandez - Harris, M.A., N.C.C, L.C.P.C
• Gwen Hernandez, RN
• Jami Hernandez

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.