Active NPI
Tanner Samuel Canaday, PT, DPT
- Neurology Physical Therapist
- Medford, OR
National Provider Identifier
1558046623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- License
- 64960
- Practice address
- 1111 Crater Lake Ave
Medford, OR 97504-6241 - Phone
- (541) 732-5686
- NPI assigned
- Jun 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | 64960 | OR | Primary |
Addresses
Primary practice location
1111 Crater Lake Ave
Medford, OR 97504-6241
Mailing address
1334 Reddy Ave
Medford, OR 97504-7056
Phone (541) 290-7073
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64960 | OR | MD | Neurology Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1558046623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1334 REDDY AVE",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047056",
"telephone_number": "541-290-7073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 CRATER LAKE AVE",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046241",
"telephone_number": "541-732-5686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANADAY",
"first_name": "TANNER",
"middle_name": "SAMUEL",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-16",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "OR",
"license": "64960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.