Jonathan Bennett McNabb, MSPT

Individual provider Active NPI Physical Therapist · Alvaton, KY

NPI 1225034945 · NPPES record last updated May 17, 2023

Key facts

NPI
1225034945
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
004115 (KY)
Practice address
395 Stone Bluff LN
Alvaton, KY 42122-9721
Phone
(270) 791-5972
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Total Fitness Connection,PLLC Past
since Nov 1, 2015
Accepting new patients
TFC Physical Therapy, PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004115 KY Yes

Addresses

Primary practice location

395 Stone Bluff LN
Alvaton, KY 42122-9721

Mailing address

395 Stone Bluff LN
Alvaton, KY 42122-9721
Phone (270) 791-5972

Other identifiers

IdentifierTypeStateIssuer
000000532436OtherKYANTHEM
P00363023OtherKYRAILROAD MEDICARE
000000310071OtherKYANTHEM
7659534OtherAETNA
87001129MedicaidKY

Other providers in Alvaton, KY

All providers in Alvaton, KY · Physical Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.