Healthcare Provider Details
I. General information
NPI: 1942136080
Provider Name (Legal Business Name): SHELMADINE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1207 W 2ND ST
ALLIANCE NE
69301-3318
US
IV. Provider business mailing address
1207 W 2ND ST
ALLIANCE NE
69301-3318
US
V. Phone/Fax
- Phone: 402-205-1610
- Fax:
- Phone: 402-205-1610
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
D
SHELMADINE
Title or Position: OWNER
Credential: DO
Phone: 402-205-1610