Active NPI
Kevin Daniel Lane, PT
- Physical Therapist
- Stockton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT20980
- Practice address
- 534 E Pine St
Suite a
Stockton, CA 95204-5536 - Phone
- (209) 463-5800
- Fax
- (209) 463-5900
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT20980 | CA | Primary |
Addresses
Primary practice location
534 E Pine St
Suite a
Stockton, CA 95204-5536
Mailing address
534 E Pine St
Suite a
Stockton, CA 95204-5536
Phone (209) 463-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2339 W Hammer LN
Suite K
Stockton, CA 95209-2368
Phone (209) 623-2500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Bear Physical Therapy Sports Injury Center, Inc | Physical Therapist | Current | Accepting new patients |
| JBJC Inc. | Physical Therapist | Current | Accepting new patients |
| JBJC Inc | Current | Accepting new patients | |
| San Luis Physical Therapy & Orthopedic Rehabilitation Inc | Physical Therapist | Past | Accepting new patients |
| San Luis Physical Therapy & Orthopedic Rehabilitation Inc | Physical Therapist | Past | Accepting new patients |
Locations
1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946
1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288
534 E Pine St
Ste A
Stockton, CA 95204
Phone (209) 463-5800
2339 W Hammer Ln
Ste K
Stockton, CA 95209
Phone (209) 623-2500
Organizations & group practices 5
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.
-
- Physical Therapy Clinic/Center
- Modesto, CA
- NPI 1811084676
Physical Therapist
-
- Physical Therapy Clinic/Center
- Stockton, CA
- NPI 1861986887
-
- Physical Therapy Clinic/Center
- Atascadero, CA
- NPI 1225046824
Physical Therapist
-
- Physical Therapy Clinic/Center
- Stockton, CA
- NPI 1578354239
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1124056536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 E PINE ST",
"address_2": "SUITE A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045536",
"telephone_number": "209-463-5800",
"fax_number": "209-463-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "534 E PINE ST",
"address_2": "SUITE A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045536",
"telephone_number": "209-463-5800",
"fax_number": "209-463-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "KEVIN",
"middle_name": "DANIEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT20980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.