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

Nathaniel Shane Coburn, PT, DPT

Individual provider Physical Therapist · NPI 1477108710

Nathaniel Shane Coburn, PT, DPT is a Physical Therapist in Private Practice in Kansas City, Missouri. Qualified in 2018, 8 years ago. Practices with Serc Rebabilitation Partners, LLC, a 211-clinician group and accepts Medicare assignment. Licensed in Kansas and Missouri.

Years since qualifying
8
Licensed in
KS, MO
In the registry since
2019
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3355 Main St
Kansas City, MO 64111-1904
Phone: (816) 399-0806
Fax: (816) 743-7413
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2019043529 (MO)
Physical Therapist Taxonomy 225100000X · Licence 11-06394 (KS)

Record details

NPI number1477108710
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedAugust 5, 2019
Last updated in NPPESMarch 31, 2020
Certification dateMarch 31, 2020

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Serc Rebabilitation Partners, Llc — 211 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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