NPIMap

Organization Active NPI

Prana Functional Manual Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lancaster, PA
National Provider Identifier
1356660146
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT017185 Issued in PA
Legal business name
PRANA FUNCTIONAL MANUAL THERAPY, LLC
Practice address
617 N Prince St
Lancaster, PA 17603-4769
Phone
(717) 390-4822
Fax
(717) 390-4825
NPI assigned
May 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Authorized official

Name
Dawn Marie Cox, CFMT, MSPTNPI 1215016456
Title
Owner, Physical Therapist
Phone
(717) 390-4822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT017185 PA Primary

Addresses

Primary practice location

617 N Prince St
Lancaster, PA 17603-4769

Mailing address

617 N Prince St
Mailbox a
Lancaster, PA 17603-4769
Phone (717) 390-4822

Other identifiers 8

IdentifierTypeStateIssuer
0128263160001MedicaidPA
1949525OtherPAHIGHMARK BLUE SHIELD
20088797OtherPAAMERIHEALTH MERCY
50093252OtherPACAPITAL BLUE CROSS
181523OtherPAMEDICARE PTAN
50081775OtherPACAPITAL BLUE CROSS PIN
1646932OtherPAHIGHMARK BLUE SHIELD
20080890OtherPAAMERIHEALTH MERCY

Other names 1

  • Prana Physical Therapy,LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100629000712 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153452560 Receives reassigned benefits from 7 practitioners
Practice locations: Lancaster, PA

National Provider Directory

National Provider Directory

Locations

617 N Prince St
Lancaster, PA 17603
Phone (717) 390-4822

274 Granite Run Dr
Lancaster, PA 17601
Phone (717) 390-4822

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1356660146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N PRINCE ST",
            "address_2": "MAILBOX A",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176034769",
            "telephone_number": "717-390-4822",
            "fax_number": "717-390-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176034769",
            "telephone_number": "717-390-4822",
            "fax_number": "717-390-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRANA FUNCTIONAL MANUAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "717-390-4822",
        "authorized_official_credential": "CFMT, MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT017185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0128263160001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1949525",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20088797",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50093252",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "181523",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS PIN",
            "identifier": "50081775",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1646932",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20080890",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prana Physical Therapy,LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.