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

Shane David Nibley

Individual provider Case Manager/Care Coordinator · NPI 1255200846

Shane David Nibley is a Case Manager/Care Coordinator in South Lake Tahoe, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025
Specialties on file
3

Practice location Address checks out

3079 Harrison Ave
South Lake Tahoe, CA 96150-7976
Phone: (530) 957-6254
Show map & directions

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

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X
Case Manager/Care Coordinator Taxonomy 171M00000X
Day Training/Habilitation Specialist Taxonomy 373H00000X (CA)

Record details

NPI number1255200846
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 1, 2025
Last updated in NPPESDecember 11, 2025
Certification dateDecember 11, 2025

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