COBURN SHANK (MSPT) – Physical Therapist, NPI 1558478263
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,303 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IA
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Provider Addresses for COBURN SHANK (MSPT)
1601, Northwest 114th Street, Clive, Polk County, Iowa, 50325, United States
SUITE 155
CLIVE, IA 503257007
Phone: (515) 222-7350
Fax: (515) 222-7355
Type: Location
PO BOX 674721
DALLAS, TX 752674721
Phone: (515) 643-2519
Fax: (515) 222-7355
Type: Mailing
1601 NW 114TH ST STE 347
CLIVE, IA 503257046
Phone: (515) 222-7350
Fax: (515) 222-7355
Type: Location
Des Moines Post Office, 1165, 2nd Avenue, Des Moines, Polk County, Iowa, 50318, United States
DES MOINES, IA 503051475
Phone: (515) 222-7350
Fax: (515) 222-7355
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-12-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041206000282 | I | Physical Therapist In Private Practice | IA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 400 | 59 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 304 | 53 | $0 |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 295 | 50 | $0 |
| 97530 | Therapy procedure using functional activities | 163 | 31 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 46 | 44 | $0 |
Insurance plans in this area (ZIP 50325)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | IA | |
| P S Y C H I A T R Y | IA | |
| - | IA | |
| Family Practice | IA | |
| - | NE | |
| Emergency Medicine | IA | |
| Family Practice | IA | |
| Physician Assistant | IA | |
| - | IA | |
| Nurse Practitioner | IA |
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