Individual provider Active NPI

Banu Melissa Acan, DPT

  • Physical Therapist
  • Lakewood Ranch, FL
National Provider Identifier
1295079440
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30466 Issued in FL
Practice address
7357 International PL
Lakewood Ranch, FL 34240-8427
Phone
(941) 500-9292
Fax
(941) 500-9292
NPI assigned
Nov 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9170 MN
Physical Therapist 225100000X 30466 FL Primary

Addresses

Primary practice location

7357 International PL
Lakewood Ranch, FL 34240-8427

Mailing address

7357 International PL
Lakewood Ranch, FL 34240-8427
Phone (941) 500-9292

Other practice location 1

2810 Nicollet Ave
Minneapolis, MN 55408-4708
Phone (612) 873-6963

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30466FLMDPhysical Therapist
9170MNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1352592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1295079440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7357 INTERNATIONAL PL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342408427",
            "telephone_number": "941-500-9292",
            "fax_number": "941-500-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7357 INTERNATIONAL PL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342408427",
            "telephone_number": "941-500-9292",
            "fax_number": "941-500-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2810 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084708",
            "country_code": "US",
            "telephone_number": "612-873-6963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACAN",
        "first_name": "BANU",
        "middle_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-11",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9170",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.