Individual provider Active NPI

Benton McCann, DPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1114751500
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4695 Issued in NE
Practice address
7686 Walnut St
Omaha, NE 68124-1717
Phone
(402) 819-8477
Fax
(855) 670-1789
NPI assigned
Aug 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 4695 NE Primary

Addresses

Primary practice location

7686 Walnut St
Omaha, NE 68124-1717

Mailing address

2221 S 141St CT Apt 17
Omaha, NE 68144-2369
Phone (785) 230-7231

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

State licenses

LicenseStateTypeSpecialty
4695NEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1114751500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 S 141ST CT APT 17",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442369",
            "telephone_number": "785-230-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7686 WALNUT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681241717",
            "telephone_number": "402-819-8477",
            "fax_number": "855-670-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "BENTON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.