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

Individual provider Physical Therapist · NPI 1780229898

Shane Ravenelle, PT, DPT is a Physical Therapist in Private Practice in Lake Forest, California. Qualified in 2019, 7 years ago. Practices with Coury and Buehler Physical Therapy Lake Forest Inc, a 7-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
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

24301 Muirlands Blvd Ste T
Lake Forest, CA 92630-3627
Phone: (949) 271-0012
Fax: (949) 271-0013
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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 297650 (CA)

Record details

NPI number1780229898
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedNovember 12, 2019
Last updated in NPPESNovember 12, 2019

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Coury And Buehler Physical Therapy Lake Forest Inc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Forest