Pro Dynamic Physical Therapy Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRO DYNAMIC PHYSICAL THERAPY INC.

Practice address

6910 Douglas Blvd Ste D
Granite Bay, CA 95746-6276

Phone

(916) 318-6964

Fax

(916) 318-6965

NPI assigned

Nov 13, 2015

Organization subpart

No

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

Authorized official

Name

Travis TanasseNPI 1811210040

Title

Owner, Physical Therapist

Phone

(916) 318-6964

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

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

• Travis Tanasse, PT

  • Physical Therapist
  • Granite Bay, CA
  • NPI 1811210040
  Medicare reassignment Care Compare group NPD Authorized official
• Katrina Myers, PT, DPT

  • Physical Therapist
  • Granite Bay, CA
  • NPI 1205685492
  Medicare reassignment Care Compare group NPD
• Megan Davis, DPT, PT

  • Physical Therapist
  • Elk Grove, CA
  • NPI 1982169637
  Medicare reassignment NPD
• Melissa McBride

  • Physical Therapist
  • Fair Oaks, CA
  • NPI 1295478618
  Medicare reassignment NPD
• Kevin Gregory Lockhart, O.D.

  • Optometrist
  • Granite Bay, CA
  • NPI 1962568329
  NPD (past)

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1437522455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 DOUGLAS BLVD STE D",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466276",
            "telephone_number": "916-318-6964",
            "fax_number": "916-318-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 DOUGLAS BLVD STE D",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466276",
            "telephone_number": "916-318-6964",
            "fax_number": "916-318-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO DYNAMIC PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "TANASSE",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "916-318-6964"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Pickett
• Placer County - Vista Creek
• Placer Psychiatry Group, Inc.
• Logan Potter
• Andrea Prichard
• Stephen Proudfoot, BT
• Jacob Marshall Pulliam
• Frank Quero
• Maira Sandra Rackley
• Ranbir Singh, DMD Dental Corp.

• Physical Therapist in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.