Individual provider Active NPI

Duan Yi Fang

  • Physical Therapist
  • Plano, TX
National Provider Identifier
1336887199
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1356223 Issued in TX
Practice address
1400 Preston Rd Ste 300
Plano, TX 75093-3603
Phone
(972) 430-6889
NPI assigned
May 23, 2022
Last updated
May 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 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 1356223 TX Primary

Addresses

Primary practice location

1400 Preston Rd Ste 300
Plano, TX 75093-3603

Mailing address

1400 Preston Rd Ste 300
Plano, TX 75093-3603
Phone (972) 755-9765

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address services@championtomorrow.com Direct Champion Rehabilitation and Support Services PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118000121 TX Practitioner - Physical Therapist in Private Practice 0244682904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center of Pelvic Excellence Physical Therapy Cope PTGroup PAC ID 2264838218, 8 clinicians

Practice addresses (Care Compare)

3721 S Stonebridge Dr
Unit 1102
McKinney, TX 75070-0236
Phone (817) 381-5177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1356223TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Multi-Specialty CurrentSince Dec 9, 2023 Accepting new patients
Center of Pelvic Excellence Physical Therapy Cope PT Multi-Specialty CurrentSince Nov 1, 2024 Accepting new patients
Legacy Healthcare Services Inc. Multi-Specialty CurrentSince Dec 9, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

12700 Hillcrest Rd
Ste 149
Dallas, TX 75230
Phone (817) 381-5110

3721 S Stonebridge Dr
Unit 1102
McKinney, TX 75070
Phone (817) 381-5177

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1336887199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PRESTON RD STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933603",
            "telephone_number": "972-755-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PRESTON RD STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933603",
            "telephone_number": "972-430-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "DUAN YI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1356223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "services@championtomorrow.com",
            "affiliation": "Y",
            "endpointDescription": "services@championtomorrow.com",
            "affiliationName": "Champion Rehabilitation and Support Services PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "services@championtomorrow.com",
            "address_1": "1400 Preston Rd Ste 300",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750933603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.