Shane Nibley
Shane Nibley is a Rehabilitation Practitioner in South Lake Tahoe, CA, registered under NPI 1255200846. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 3079 HARRISON AVE, South Lake Tahoe, CA 96150. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Rehabilitation Practitioner covers
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. NUCC Health Care Provider Taxonomy, code 225400000X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | — | — | |
| 225400000X | Rehabilitation Practitioner | — | — | primary |
| 373H00000X | Day Training/Habilitation Specialist | — | CA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1255200846 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Nov 1, 2025 |
| Last updated | Dec 11, 2025 |
| Status | Active |
| Sole proprietor | No |
| Gender | Male |
| Practice address |
3079 HARRISON AVE South Lake Tahoe, CA 96150 (530) 957-6254 |
| Mailing address |
406 SUNRISE AVE STE 300 Roseville, CA 95661 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 2 | 5 | 5 | 2 | 0 | 0 | 8 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 1 | 5 | 4 | 0 | 0 | 8 | 8 |
Sum = 54 · next multiple of 10 = 60 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.