Individual provider Active NPI

Kyle J Gangidine-Daley, DPT

  • Physical Therapist
  • Cuyahoga Falls, OH
National Provider Identifier
1174120752
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018221 Issued in OH
Practice address
1251 Main St Ste a
Cuyahoga Falls, OH 44221
Phone
(330) 928-2273
Fax
(330) 922-4088
NPI assigned
Oct 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 PT018221 OH Primary

Addresses

Primary practice location

1251 Main St Ste a
Cuyahoga Falls, OH 44221

Mailing address

1251 Main St Ste a
Cuyahoga Falls, OH 44221-4917
Phone (330) 928-2273

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
PT018221OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Chiropractic Health & Wellness Center LLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

1251 Main St
Ste A
Cuyahoga Fls, OH 44221
Phone (330) 928-2273

Organizations & group practices 1

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1174120752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 MAIN ST STE A",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442214917",
            "telephone_number": "330-928-2273",
            "fax_number": "330-922-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 MAIN ST STE A",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "44221",
            "telephone_number": "330-928-2273",
            "fax_number": "330-922-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGIDINE-DALEY",
        "first_name": "KYLE",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT018221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.