Individual provider Active NPI

Ian Honaker

  • Physical Therapist
  • Beckley, WV
National Provider Identifier
1336593359
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
202 Guadalcanal Ave
Beckley, WV 25801-8060
Phone
(304) 228-7620
NPI assigned
Apr 15, 2016
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 21030312600 WV
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

202 Guadalcanal Ave
Beckley, WV 25801-8060

Mailing address

202 Guadalcanal Ave
Beckley, WV 25801-8060
Phone (304) 228-7620

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
71.18
Promoting interoperability
92
Improvement activities
40
Cost
79.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21030312600WVMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Valley Physical Therapy LLC CurrentSince Oct 25, 2021 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Greenbrier Valley Physical Therapy, LLC Physical Therapist Current Accepting new patients

Locations

155 Reston Pl
Gassaway, WV 26624
Phone (304) 228-7620

3942 Davis Stuart Rd
Ste 3
Ronceverte, WV 24970
Phone (304) 647-3987

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1336593359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 GUADALCANAL AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258018060",
            "telephone_number": "304-228-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 GUADALCANAL AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258018060",
            "telephone_number": "304-228-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONAKER",
        "first_name": "IAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": "21030312600",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.