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

Shelby Rae Jimenez, PTA

Individual provider Physical Therapy Assistant · NPI 1720568611

Shelby Rae Jimenez, PTA is a Physical Therapist in Private Practice in Wasilla, Alaska. Qualified in 2016, 10 years ago. Practices as a sole proprietor. Licensed in Alaska.

Years since qualifying
10
Licensed in
AK
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

3190 E Meridian Park Loop Ste 206A
Wasilla, AK 99654-7422
Phone: (907) 373-9462
Fax: (907) 373-9463
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 116806 (AK)

Record details

NPI number1720568611
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedAugust 20, 2018
Last updated in NPPESAugust 20, 2018

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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