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General NPI Number Information
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NPI Number | 1558141226
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Entity Type | Individual
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Provider Name | SAMANTHA SHIVELY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1805 SHEA CENTER DR STE 160
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2253
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Country | US
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Telephone | 720-480-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 SHEA CENTER DR STE 160
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2253
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP044892T
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29954
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License Number State | MD
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