Individual provider Active NPI

Stephen J Feehan, DPT

  • Physical Therapist
  • Lafayette, IN
National Provider Identifier
1407323033
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05014535A Issued in IN
Practice address
3218 Daugherty Dr Ste 160
Lafayette, IN 47909-4402
Phone
(765) 477-6464
Fax
(765) 477-6262
NPI assigned
Nov 1, 2018
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 2018039706 MO
Physical Therapist 225100000X 05014535A IN Primary

Addresses

Primary practice location

3218 Daugherty Dr Ste 160
Lafayette, IN 47909-4402

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

18077 River Rd Ste 200
Noblesville, IN 46062-8334
Phone (317) 776-7028

Other identifiers 1

IdentifierTypeStateIssuer
2018039706OtherMOPHYSICAL THERAPY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616000339 IN Practitioner - Physical Therapist in Private Practice 9133463706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1909 Veterans Memorial Pkwy S
Suite 100
Lafayette, IN 47909-9401

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018039706MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

3218 Daugherty Dr
Ste 160
Lafayette, IN 47909
Phone (765) 477-6464

2718 US Highway 52 W
Ste C
West Lafayette, IN 47906
Phone (765) 237-3508

Organizations & group practices 2

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1407323033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 DAUGHERTY DR STE 160",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479094402",
            "telephone_number": "765-477-6464",
            "fax_number": "765-477-6262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18077 River Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460628334",
            "country_code": "US",
            "telephone_number": "317-776-7028",
            "fax_number": "317-773-7910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEEHAN",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2018039706",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014535A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "2018039706",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.