Shane T. Phillips, MED, ATC/L, PES
NPI 1063283463ActiveIndividual· Specialist/Technologist, Athletic Trainer· Anchorage, AK
Specialist/Technologist, Athletic Trainer (MED, ATC/L, PES) in Anchorage, Alaska, licensed in IA, with an NPI issued in January 2024.
Overview
| NPI | 1063283463 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MED, ATC/L, PES |
| Sole proprietor | No |
| NPI issued | Jan 15, 2024 |
| Last updated in NPPES | Jan 15, 2024 |
| Certified by provider | Jan 12, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist/Technologist, Athletic Trainer Primary | 2255A2300X | 123978 | IA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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