Individual provider Active NPI

David W Candy, PT, DPT, OCS, ATC

  • Physical Therapist
  • Manchester, MO
National Provider Identifier
1457587206
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2013038162 Issued in MO
Practice address
14585 Manchester Rd
Manchester, MO 63011-3963
Phone
(314) 941-3970
Fax
(314) 931-1352
NPI assigned
Jun 8, 2009
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 2013038162 MO Primary
Athletic Trainer 2255A2300X 2013037334 MO

Addresses

Primary practice location

14585 Manchester Rd
Manchester, MO 63011-3963

Mailing address

14585 Manchester Rd
Manchester, MO 63011-3963
Phone (314) 941-3970

Other practice location 1

47 Nationalway Shopping Ctr
Manchester, MO 63011
Phone (314) 941-3970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207002917 MO Practitioner - Physical Therapist in Private Practice 3577846088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14585 Manchester Rd
Manchester, MO 63011-3963
Phone (314) 941-3970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013038162MOMDPhysical Therapist
2013037334MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Movement 4 Life Physical Therapy, LLC Physical Therapist CurrentSince Sep 16, 2017 Accepting new patients

Locations

14585 Manchester Rd
Manchester, MO 63011
Phone (314) 941-3970

47 Nationalway Shopping Ctr
Manchester, MO 63011
Phone (314) 941-3970

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, 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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1457587206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14585 MANCHESTER RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630113963",
            "telephone_number": "314-941-3970",
            "fax_number": "314-931-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14585 MANCHESTER RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630113963",
            "telephone_number": "314-941-3970",
            "fax_number": "314-931-1352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Nationalway Shopping Ctr",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "MO",
            "postal_code": "63011",
            "country_code": "US",
            "telephone_number": "314-941-3970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANDY",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "PT, DPT, OCS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2022-08-19",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2013038162",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2013037334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.