Individual provider Active NPI

Mark C Vanloan, P.T.

  • Physical Therapist
  • Redding, CA
National Provider Identifier
1063589919
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26561 Issued in CA
Practice address
1920 California St
Redding, CA 96001-1943
Phone
(530) 243-1102
Fax
(530) 243-1123
NPI assigned
Nov 29, 2006
Last updated
Aug 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 PT26561 CA Primary

Addresses

Primary practice location

1920 California St
Redding, CA 96001-1943

Mailing address

1920 California St
Redding, CA 96001-1943
Phone (530) 243-1102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051101000497 CA Practitioner - Physical Therapist in Private Practice 3577580224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1388 Court St
Suite K
Redding, CA 96001-1650
Phone (530) 241-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26561CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swell Endeavors Physical Therapy, Inc Physical Therapist CurrentSince May 7, 2018 Accepting new patients
Snow Ghost Physical Therapy LLC Physical Therapist Current Accepting new patients
RPT Management Company Past Accepting new patients
Redding Physical Therapy, L.P. Physical Therapist Past Accepting new patients

Locations

1388 Court St
Ste K
Redding, CA 96001
Phone (530) 241-1900

2770 Eureka Way
Ste 100
Redding, CA 96001
Phone (530) 222-7271

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1063589919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 CALIFORNIA ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011943",
            "telephone_number": "530-243-1102",
            "fax_number": "530-243-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 CALIFORNIA ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011943",
            "telephone_number": "530-243-1102",
            "fax_number": "530-243-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLOAN",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.