Active NPI
John Ryan Canale, PT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1689822736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1341
- Practice address
- 3515 Glenwood Ave
Raleigh, NC 27612-4934 - Phone
- (919) 863-6873
- Fax
- (919) 781-5246
- NPI assigned
- Sep 3, 2008
- 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 | 1341 | NC | Primary |
Addresses
Primary practice location
3515 Glenwood Ave
Raleigh, NC 27612-4934
Mailing address
3515 Glenwood Ave
Raleigh, NC 27612-4934
Phone (919) 863-6873
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1341 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1689822736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 GLENWOOD AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276124934",
"telephone_number": "919-863-6873",
"fax_number": "919-781-5246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 GLENWOOD AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276124934",
"telephone_number": "919-863-6873",
"fax_number": "919-781-5246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANALE",
"first_name": "JOHN",
"middle_name": "RYAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-03",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "1341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.