Individual provider Active NPI

Ryan J Teknipp, DPT

  • Orthopedic Physical Therapist
  • Columbus, OH
National Provider Identifier
1043798119
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT018101 Issued in OH
Practice address
1210 Gemini PL Ste 200
Columbus, OH 43240-6110
Phone
(614) 262-0907
Fax
(614) 262-5269
NPI assigned
Aug 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT018101 OH Primary

Addresses

Primary practice location

1210 Gemini PL Ste 200
Columbus, OH 43240-6110

Mailing address

1210 Gemini PL
Ste 200
Columbus, OH 43240-6110
Phone (614) 262-0907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190703000643 OH Practitioner - Physical Therapist in Private Practice 8527305556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vine Performance Therapy LLCGroup PAC ID 1355736083, 2 clinicians

Practice addresses (Care Compare)

400 Lazelle Rd
Suite 10
Columbus, OH 43240-2077
Phone (740) 936-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT018101OHMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vine Performance Therapy LLC Physical Therapist CurrentSince Feb 22, 2022 Accepting new patients

Locations

400 Lazelle Rd
Ste 10
Columbus, OH 43240
Phone (614) 436-3909

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1043798119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 GEMINI PL",
            "address_2": "STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432406110",
            "telephone_number": "614-262-0907",
            "fax_number": "614-262-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 GEMINI PL STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432406110",
            "telephone_number": "614-262-0907",
            "fax_number": "614-262-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKNIPP",
        "first_name": "RYAN",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT018101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.