Individual provider Active NPI

John T Gavigan, DPT

  • Physical Therapist
  • Yardley, PA
National Provider Identifier
1093060196
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-022165 Issued in PA
Practice address
103 Floral Vale Blvd
Yardley, PA 19067-5522
Phone
(215) 860-4270
Fax
(215) 860-2270
NPI assigned
Jul 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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 PT-022165 PA Primary

Addresses

Primary practice location

103 Floral Vale Blvd
Yardley, PA 19067-5522

Mailing address

101 Park Place Dr
Sinking Spring, PA 19608-9779
Phone (484) 955-6543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260429000124 MD Practitioner - Physical Therapist in Private Practice 1759858640 Reassigns benefits to 1 organization
I20260429000906 DC Practitioner - Physical Therapist in Private Practice 1759858640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1006 Chilmark CT
Crofton, MD 21114-3274

9105 E Stayman Dr
Ellicott City, MD 21042-1823

PO Box
Suite 290609
Nashville, TN 37229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-022165PAMDPhysical Therapist

Organizations & group practices 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1093060196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PARK PLACE DR",
            "city": "SINKING SPRING",
            "state": "PA",
            "postal_code": "196089779",
            "telephone_number": "484-955-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FLORAL VALE BLVD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675522",
            "telephone_number": "215-860-4270",
            "fax_number": "215-860-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIGAN",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-022165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.