NPIMap

Organization Active NPI

Freedom Physical Therapy and Training Center PA

  • Physical Therapy Clinic/Center
  • Shawnee, KS
National Provider Identifier
1609267913
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FREEDOM PHYSICAL THERAPY AND TRAINING CENTER PA
Practice address
7740 Hedge Lane Ter
Shawnee, KS 66227-3017
Phone
(913) 745-7537
NPI assigned
Feb 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Dr. Don Clyde Dequine Jr., PTNPI 1871984161
Title
DPT
Phone
(408) 489-3836

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

7740 Hedge Lane Ter
Shawnee, KS 66227-3017

Mailing address

7740 Hedge Lane Ter
Shawnee, KS 66227-3017

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150413000815 KS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153649777 Receives reassigned benefits from 5 practitioners
Practice locations: Shawnee, KS

National Provider Directory

National Provider Directory

Locations

7740 Hedge Lane Ter
Shawnee, KS 66227
Phone (913) 299-7100

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1609267913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 HEDGE LANE TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662273017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 HEDGE LANE TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662273017",
            "telephone_number": "913-745-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM PHYSICAL THERAPY AND TRAINING CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "DEQUINE",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "DPT",
        "authorized_official_telephone_number": "408-489-3836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.