Active NPI
Richard Alan Clendaniel, PT
- Physical Therapist
- Durham, NC
National Provider Identifier
1568546166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P4928
- Practice address
- 1005 Slater Rd
Suite 120
Durham, NC 27703-8448 - Phone
- (919) 684-8111
- NPI assigned
- Oct 24, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P4928 | NC | Primary |
Addresses
Primary practice location
1005 Slater Rd
Suite 120
Durham, NC 27703-8448
Mailing address
4101 N Roxboro St
Durham, NC 27704-2121
Phone (919) 684-8111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
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
- Group practices
Practice addresses (Care Compare)
2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P4928 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke University Health System, Inc. | Physical Therapist | Current | Accepting new patients |
| Duke University Health System, Inc. | Current | Accepting new patients | |
| Private Diagnostic Clinic PLLC | Physical Therapist | Past | Accepting new patients |
Locations
2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289
5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700
Organizations & group practices 3
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.
-
- Certified Registered Nurse Anesthetist
- Durham, NC
- NPI 1558392977
Physical Therapist
-
- Parenteral & Enteral Nutrition Supplies (DME)
- Durham, NC
- NPI 1427187525
-
- Physical Therapist
- Durham, NC
- NPI 1730267089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191542400000",
"number": "1568546166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 N ROXBORO ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042121",
"telephone_number": "919-684-8111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 SLATER RD",
"address_2": "SUITE 120",
"city": "DURHAM",
"state": "NC",
"postal_code": "277038448",
"telephone_number": "919-684-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLENDANIEL",
"first_name": "RICHARD",
"middle_name": "ALAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P4928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.