Provider Type Icon

SHANE ROTHERMEL MD NPI 1083000541


NPI Information

NPI: 1083000541
Provider Name: SHANE ROTHERMEL, MD
Classification: Orthopaedic Surgery - 207XS0114X
Entity Type: Individual

Specialization: Adult Reconstructive Orthopaedic Surgery

Organization: PARKVIEW ANCILLARY SERVICES CORPORATION

PECOS Registration: Yes

Address:
3676 PARKER BLVD STE 390
PUEBLO, CO
ZIP 81008
Phone: (719) 595-7780
Get Directions

Shane Rothermel, MD is an adult reconstructive orthopaedic surgery orthopaedic surgery in Pueblo, CO with 9 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. Shane Rothermel, MD NPI is 1083000541. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2015

The provider's business location address is:

3676 PARKER BLVD STE 390
PUEBLO, CO
ZIP 81008-215
Phone: (719) 595-7780
Fax: (719) 595-7789

The NPI 1083000541 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/11/2015 and was last updated on 10/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery25MA10759000NEW JERSEYNo
2207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryMD462106PENNSYLVANIANo
3390200000XStudent in an Organized Health Care Education/Training ProgramNo
4207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryDR0065962COLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.