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

Shantay Anderson

Individual provider Physical Therapy Assistant · NPI 1942829205

Shantay Anderson is a Physical Therapy Assistant in Pocatello, Idaho. Licensed in Idaho and Utah. Registered with an NPI since 2020.

Licensed in
ID, UT
In the registry since
2020
Specialties on file
2

Practice location Address checks out

527 Memorial Dr
Pocatello, ID 83201-4063
Phone: (208) 478-3333
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA-6180 (ID)
Physical Therapy Assistant Taxonomy 225200000X · Licence 11433285-2402 (UT)

Record details

NPI number1942829205
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 15, 2020
Last updated in NPPESApril 15, 2020
Certification dateApril 15, 2020
Mailing address5277 Stuart Ave, Pocatello, ID 83202-2201

Other providers in Pocatello