Individual provider Active NPI

Ian Craig Danis, DPT

  • Physical Therapist
  • Elizabethtown, KY
National Provider Identifier
1023536372
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007263 Issued in KY
Practice address
4031 N Dixie Hwy Ste 104
Elizabethtown, KY 42701
Phone
(270) 982-4776
Fax
(270) 982-4778
NPI assigned
Sep 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 007263 KY Primary

Addresses

Primary practice location

4031 N Dixie Hwy Ste 104
Elizabethtown, KY 42701

Mailing address

383 Corbin Center Dr
Corbin, KY 40701-1895
Phone (606) 526-2913

Other identifiers 1

IdentifierTypeStateIssuer
7100493930MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215001546 KY Practitioner - Physical Therapist in Private Practice 0648538827 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT Pros, Inc. Physical Therapist CurrentSince Nov 11, 2017 Accepting new patients
PT Pros, Inc. Physical Therapist CurrentSince Nov 11, 2017 Accepting new patients
PT Pros, Inc. Physical Therapist Current Accepting new patients

Locations

383 Corbin Center Dr
Corbin, KY 40701
Phone (606) 526-2909

4031 N Dixie Hwy
Ste 104
Elizabethtown, KY 42701
Phone (270) 982-4776

201 S Main St
Leitchfield, KY 42754
Phone (270) 230-1729

Organizations & group practices 3

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": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1023536372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 CORBIN CENTER DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011895",
            "telephone_number": "606-526-2913",
            "fax_number": "606-526-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 N DIXIE HWY STE 104",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "42701",
            "telephone_number": "270-982-4776",
            "fax_number": "270-982-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIS",
        "first_name": "IAN",
        "middle_name": "CRAIG",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100493930",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.