Kelly Shepherd, DPT
NPI 1215521638ActiveIndividual· Physical Therapist· Moab, UT
Physical Therapist (DPT) with Centura Ventures, LLC, practicing in Moab, Utah. Enrolled in Medicare as practitioner - physical therapist in private practice and practitioner - physical therapist in private practice.
Overview
| NPI | 1215521638 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Feb 25, 2021 |
| Last updated in NPPES | Aug 27, 2025 |
| Certified by provider | Aug 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 12148961-2401 | UT |
| Physical Therapist | 225100000X | PTL.0020733 | CO |
| Physical Therapist | 225100000X | 12590 | SC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (CO); Practitioner - Physical Therapist in Private Practice (SC) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Centura Ventures, LLCColorado Springs, CO · 30 clinicians
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