Individual provider Active NPI

Dean Mason Kannier, P.T.

  • Physical Therapist
  • Redding, CA
National Provider Identifier
1407931751
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18430 Issued in CA
Practice address
951 Butte St
Redding, CA 96001-0828
Phone
(530) 241-9142
Fax
(530) 241-9201
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT18430 CA Primary

Addresses

Primary practice location

951 Butte St
Redding, CA 96001-0828

Mailing address

951 Butte St
Redding, CA 96001-0828
Phone (530) 241-9142

Other identifiers 1

IdentifierTypeStateIssuer
PT0184300MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050825000961 CA Practitioner - Physical Therapist in Private Practice 8820029358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

951 Butte St
Redding, CA 96001-0828
Phone (530) 241-9142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT18430CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
NVPT, Inc. Physical Therapist CurrentSince Aug 1, 2005 Accepting new patients

Locations

951 Butte St
Redding, CA 96001
Phone (530) 241-9142

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407931751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 BUTTE ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010828",
            "telephone_number": "530-241-9142",
            "fax_number": "530-241-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 BUTTE ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010828",
            "telephone_number": "530-241-9142",
            "fax_number": "530-241-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNIER",
        "first_name": "DEAN",
        "middle_name": "MASON",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT18430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0184300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.