Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shane Blake Anderson, DO

Individual provider Diagnostic Radiology Physician · NPI 1144208661

Dr. Shane Blake Anderson, DO is a Diagnostic Radiology in Murray, Utah. Qualified in 2002, 24 years ago. Practices with Mountain Medical Physician Specialists PC, a 30-clinician group and accepts Medicare assignment. Licensed in Nebraska and Utah.

Years since qualifying
24
Licensed in
NE, UT
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

5334 S Woodrow St Ste 100
Murray, UT 84107-5838
Phone: (801) 713-0600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 328507-1204 (UT)
Nuclear Imaging & Therapy Physician Taxonomy 207UN0902X · Licence 378 (NE)
Nuclear Medicine Physician Taxonomy 207U00000X · Licence 328507-1204 (UT)

Record details

NPI number1144208661
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJanuary 4, 2006
Last updated in NPPESApril 27, 2026
Certification dateApril 27, 2026
Mailing address5334 S Woodrow St Ste 100, Murray, UT 84107-5838

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Mountain Medical Physician Specialists Pc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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