Individual provider Active NPI

Edward J. Kane, PT,PHD,ATC,ECS,SCS

  • Clinical Electrophysiology Physical Therapist
  • San Marcos, CA
National Provider Identifier
1477524635
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X
License
41 Issued in CA
Practice address
700 Windy Point Dr
San Marcos, CA 92069-1701
Phone
(760) 591-3012
Fax
(760) 591-3053
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11437 CA
Clinical Electrophysiology Physical Therapist 2251E1300X 41 CA Primary
Sports Physical Therapist 2251S0007X
Athletic Trainer 2255A2300X

Addresses

Primary practice location

700 Windy Point Dr
San Marcos, CA 92069-1701

Mailing address

700 Windy Point Dr
San Marcos, CA 92069-1701
Phone (760) 591-3012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
41CAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1477524635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WINDY POINT DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691701",
            "telephone_number": "760-591-3012",
            "fax_number": "760-591-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WINDY POINT DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920691701",
            "telephone_number": "760-591-3012",
            "fax_number": "760-591-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "EDWARD",
        "middle_name": "J.",
        "credential": "PT,PHD,ATC,ECS,SCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "11437",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "CA",
            "license": "41",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.