Kandace Davis, PT
Individual provider Active NPI Physical Therapist · Gothenburg, NE
NPI 1205988979 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205988979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1375 (NE)
- Practice address
- 1307 Lake Ave
Gothenburg, NE 69138-1744 - Phone
- (308) 325-9140
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1375 | NE | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandhills Physical Therapy and Sports Rehab P.C. | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1375 | NE | Yes |
Addresses
Primary practice location
1307 Lake Ave
Gothenburg, NE 69138-1744
Mailing address
1307 Lake Ave
Gothenburg, NE 69138-1744
Phone (308) 325-9140
Other providers in Gothenburg, NE
- Craig D Bartruff M.D., P.C.
- Craig D Bartruff, M.D., P.C.
- John Alan Daup
- David Hult, M.D., P.C.
- Carson Lee Davis
- Colby Thomas Delatour
- Lacy J Dye
- Jackie E Erb
- Family and Sport Medicine, PC
- Robyn Favinger
All providers in Gothenburg, NE · Physical Therapist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.