Basic Information
Provider Information
NPI: 1831817436
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRISEY
FirstName: SHANNON
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1225 SANTA FE DR UNIT 332
Address2:  
City: DENVER
State: CO
PostalCode: 802043531
CountryCode: US
TelephoneNumber: 9788465568
FaxNumber:  
Practice Location
Address1: 4700 HALE PKWY STE 550
Address2:  
City: DENVER
State: CO
PostalCode: 802204053
CountryCode: US
TelephoneNumber: 3033216600
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/19/2022
LastUpdateDate: 08/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000XPTL.0018610COY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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