| Shellman Inc Pa | |
|
1917 N Lakewood Dr, Coeur D Alene, ID 83814-2634 | |
| (208) 664-8194 | |
| (208) 667-1847 |
| Full Name | Shellman Inc Pa |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1917 N Lakewood Dr, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326050253 | NPI | - | NPPES |
| 002778800 | Medicaid | ID | |
| 0051780 | Other | WA | GROUP PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | MULTIPLE PROVIDERS (Idaho) | Primary |
| Provider Name | David B Andrews |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356361406 PECOS PAC ID: 7618920166 Enrollment ID: I20050224000871 |
| Provider Name | Cory I Lewis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467496323 PECOS PAC ID: 3375547680 Enrollment ID: I20060829000141 |
| Provider Name | Allan John Joubert |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205899390 PECOS PAC ID: 7012903651 Enrollment ID: I20080228000227 |
| Provider Name | Jeremy A Dye |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053534461 PECOS PAC ID: 3173691458 Enrollment ID: I20081014000617 |
| Provider Name | Adam M Borg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093977589 PECOS PAC ID: 7315015609 Enrollment ID: I20081014000663 |
| Provider Name | Justin Kane |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114957073 PECOS PAC ID: 0345293007 Enrollment ID: I20090507000144 |
| Provider Name | Melissa Anne Jacobson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1801117841 PECOS PAC ID: 9830221886 Enrollment ID: I20100709000748 |
| Provider Name | Debora Caires Nelson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093742397 PECOS PAC ID: 1658564646 Enrollment ID: I20101022000478 |
| Provider Name | John P Sayler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295821247 PECOS PAC ID: 7719901586 Enrollment ID: I20110504000619 |
| Provider Name | Mathew Hankes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073783932 PECOS PAC ID: 4880768274 Enrollment ID: I20110711000514 |
| Provider Name | Rusty Marion Wood |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295034684 PECOS PAC ID: 1759549223 Enrollment ID: I20120301000235 |
| Provider Name | Todd V Cook |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134297195 PECOS PAC ID: 2163605742 Enrollment ID: I20120724000779 |
| Provider Name | Stephanie Alyse Morrison |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902242191 PECOS PAC ID: 6608015615 Enrollment ID: I20130625000067 |
| Provider Name | Zachary W Parks |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619309333 PECOS PAC ID: 6103050158 Enrollment ID: I20131008000222 |
| Provider Name | Shawna L Clegg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265741730 PECOS PAC ID: 4082893144 Enrollment ID: I20150804003176 |
| Provider Name | Cristen J Durrant |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841646056 PECOS PAC ID: 3779874896 Enrollment ID: I20160621001802 |
| Provider Name | Kristoff Joseph Saurette |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275769218 PECOS PAC ID: 1052667201 Enrollment ID: I20180702001781 |
| Provider Name | Erin Michelle Blakley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750871349 PECOS PAC ID: 2062769474 Enrollment ID: I20180717001107 |
| Provider Name | Timothy J Conley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861956237 PECOS PAC ID: 0446593313 Enrollment ID: I20190515003297 |
| Provider Name | Connor Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730740465 PECOS PAC ID: 8628305364 Enrollment ID: I20190805000025 |
| Provider Name | Travis Blue Barlow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477741254 PECOS PAC ID: 5294901757 Enrollment ID: I20190822003457 |
| Provider Name | Bradley Davis Kruger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497315253 PECOS PAC ID: 8022347814 Enrollment ID: I20190903003286 |
| Provider Name | Luke Jack Haxton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972135010 PECOS PAC ID: 7214365097 Enrollment ID: I20200309001943 |
| Provider Name | Keagan Scott Shillington |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083249197 PECOS PAC ID: 9739518382 Enrollment ID: I20200401003212 |
| Provider Name | Jillienne Marie Braucher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518581909 PECOS PAC ID: 7012338478 Enrollment ID: I20200611000017 |
| Provider Name | Shelby Lynn Fruechte |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801419544 PECOS PAC ID: 2062834906 Enrollment ID: I20200622002103 |
| Provider Name | Joseph T Kersh |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245842517 PECOS PAC ID: 1557789575 Enrollment ID: I20200908001977 |
| Provider Name | Steve P Lane |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609889534 PECOS PAC ID: 4183620511 Enrollment ID: I20201105001722 |
| Provider Name | Jared S Anderson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912375494 PECOS PAC ID: 4981913662 Enrollment ID: I20210107001813 |
| Provider Name | Alex W Teade |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174175145 PECOS PAC ID: 3072945831 Enrollment ID: I20210114002025 |
| Provider Name | Shannon Diane Christianson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003001975 PECOS PAC ID: 9638207293 Enrollment ID: I20210419002613 |
| Provider Name | Jason Matthew Vaughn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376864256 PECOS PAC ID: 9830215862 Enrollment ID: I20210420001605 |
| Provider Name | Ben John Baarspul |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063522928 PECOS PAC ID: 2769481217 Enrollment ID: I20210930000843 |
| Provider Name | Matthew William Bray |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710544127 PECOS PAC ID: 5496082901 Enrollment ID: I20211123003149 |
| Provider Name | Taryne Nicole Thomas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912667239 PECOS PAC ID: 1557753456 Enrollment ID: I20220127000915 |
| Provider Name | Lynette Paula Thoms |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619365855 PECOS PAC ID: 9436545563 Enrollment ID: I20220329002741 |
| Provider Name | Krista Anne Kane |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1790437424 PECOS PAC ID: 6406242296 Enrollment ID: I20220404001614 |
| Provider Name | Brenden Charles Leaming |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801534789 PECOS PAC ID: 9335528256 Enrollment ID: I20220623002704 |
| Provider Name | Nathaniel Jay Delegard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043940679 PECOS PAC ID: 9335529023 Enrollment ID: I20220712002830 |
| Provider Name | Zachary Hamer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558099630 PECOS PAC ID: 5799168993 Enrollment ID: I20230419001075 |
| Provider Name | Richard Alan Young |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255909800 PECOS PAC ID: 2365845369 Enrollment ID: I20230426001042 |
| Provider Name | Edward Michael Daris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831565050 PECOS PAC ID: 3779899497 Enrollment ID: I20230906000189 |
| Provider Name | Gregory John Oellig Gould |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962960724 PECOS PAC ID: 1355775404 Enrollment ID: I20230919003194 |
| Provider Name | Jacquelyn Rose Mallet |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962243063 PECOS PAC ID: 9234672973 Enrollment ID: I20240621002681 |
| Provider Name | Brandon Richard Schwintek |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093556912 PECOS PAC ID: 8426594664 Enrollment ID: I20240723004454 |
| Provider Name | Jacob Dewulf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295465425 PECOS PAC ID: 8325416837 Enrollment ID: I20240828005376 |
| Provider Name | Leah Joy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043754112 PECOS PAC ID: 6204377591 Enrollment ID: I20240926002872 |
| Provider Name | Kelli Jean Kenser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548075443 PECOS PAC ID: 6204356462 Enrollment ID: I20250219001106 |
| Provider Name | Cooper Noble Thomas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912703273 PECOS PAC ID: 2961926209 Enrollment ID: I20250408003702 |
| Mailing Address | Practice Location Address |
|---|---|
| Shellman Inc Pa 1917 N Lakewood Dr, Coeur D Alene, ID 83814-2634 Ph: (208) 664-8194 | Shellman Inc Pa 1917 N Lakewood Dr, Coeur D Alene, ID 83814-2634 Ph: (208) 664-8194 |
Mark Andrew Stevens, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1812 N Lakewood Dr Ste 100, Coeur D Alene, ID 83814 Phone: 208-966-4475 Fax: 208-966-4475 | |
Gracee Elizabeth Lassen, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 411 W Haycraft Ave Ste D1, Coeur D Alene, ID 83815 Phone: 208-664-2468 | |
Mrs. Holly D Bruns, M.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 W Aqua Ave, Coeur D Alene, ID 83815 Phone: 208-762-1122 | |
Dr. Sharron Elizabeth Mcmillan, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 411 W Haycraft Ave Ste D4, Coeur D Alene, ID 83815 Phone: 208-664-2468 | |
Jonathan Hoelzen, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1088 W Prairie Ave, Coeur D Alene, ID 83815 Phone: 208-772-6609 | |
Competitive Fitness, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1321 W Northwood Center Ct, Suite B, Coeur D Alene, ID 83814 Phone: 208-665-7055 Fax: 208-665-7093 | |
Orthopedic Surgery And Sports Physical Therapist Medicare: Medicare Enrolled Practice Location: 850 W Ironwood Dr Ste 202, Coeur D Alene, ID 83814 Phone: 208-664-2175 Fax: 208-664-1226 |