Individual provider Active NPI

Andrew L McInnis, DPT

  • Physical Therapist
  • Hoover, AL
National Provider Identifier
1396390001
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH9475 Issued in AL
Practice address
1021 Brocks Gap Pkwy Ste 115
Hoover, AL 35244-4076
Phone
(205) 307-0525
Fax
(205) 453-4221
NPI assigned
Aug 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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 PTH9475 AL Primary

Addresses

Primary practice location

1021 Brocks Gap Pkwy Ste 115
Hoover, AL 35244-4076

Mailing address

4 Office Park Cir Ste 217
Mountain BRK, AL 35223-2674
Phone (205) 263-2770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816001261 MT Practitioner - Physical Therapist in Private Practice 7517297724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Peak Physical Therapy IncGroup PAC ID 5193637262, 42 clinicians

Practice addresses (Care Compare)

32 Market PL
Big Sky, MT 59716-7885
Phone (406) 995-7525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH9475ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Peak Physical Therapy Inc. Physical Therapist CurrentSince Jul 18, 2022 Accepting new patients
Lone Peak Physical Therapy Inc Physical Therapist CurrentSince Jul 18, 2022 Accepting new patients
Ew Motion Therapy Meadowbrook LLC Physical Therapist PastSince Aug 1, 2019 Accepting new patients

Locations

312 W Main St
Ste 1
Belgrade, MT 59714
Phone (406) 388-2235

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": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1396390001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OFFICE PARK CIR STE 217",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232674",
            "telephone_number": "205-263-2770",
            "fax_number": "205-263-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 BROCKS GAP PKWY STE 115",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444076",
            "telephone_number": "205-307-0525",
            "fax_number": "205-453-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "ANDREW",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH9475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.