Individual provider Active NPI

Behdad Tahayori

  • Physical Therapist
  • La Porte, IN
National Provider Identifier
1134520083
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011194A Issued in IN
Practice address
1203 Washington St
The Crossing Rehabilitation Center
La Porte, IN 46350-3221
Phone
(219) 326-2397
NPI assigned
Sep 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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 05011194A IN Primary

Addresses

Primary practice location

1203 Washington St
The Crossing Rehabilitation Center
La Porte, IN 46350-3221

Mailing address

1203 Washington St
The Crossing Rehabilitation Center
La Porte, IN 46350-3221
Phone (219) 326-2397

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
05011194AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1134520083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 WASHINGTON ST",
            "address_2": "THE CROSSING REHABILITATION CENTER",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503221",
            "telephone_number": "219-326-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 WASHINGTON ST",
            "address_2": "THE CROSSING REHABILITATION CENTER",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503221",
            "telephone_number": "219-326-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHAYORI",
        "first_name": "BEHDAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-10",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011194A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.