Active NPI
Calvin James Canine, PT
- Physical Therapist
- Mexico, MO
National Provider Identifier
1003060104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00573
- Practice address
- 2759 S Clark St
Suite a
Mexico, MO 65265-3720 - Phone
- (573) 581-1880
- NPI assigned
- Nov 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00573 | MO | Primary |
Addresses
Primary practice location
2759 S Clark St
Suite a
Mexico, MO 65265-3720
Mailing address
2759 S Clark St
Suite a
Mexico, MO 65265-3720
Phone (573) 581-1880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri Central Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1003060104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2759 S CLARK ST",
"address_2": "SUITE A",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653720",
"telephone_number": "573-581-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2759 S CLARK ST",
"address_2": "SUITE A",
"city": "MEXICO",
"state": "MO",
"postal_code": "652653720",
"telephone_number": "573-581-1880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANINE",
"first_name": "CALVIN",
"middle_name": "JAMES",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-17",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "00573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.