Active NPI
Pranav Purushottambhai Bhanushali
- Physical Therapist
- Wichita Falls, TX
National Provider Identifier
1700285970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 62 037159
- Practice address
- 4700 Taft Blvd
Apt 197
Wichita Falls, TX 76308-4802 - Phone
- (940) 228-6825
- NPI assigned
- Aug 14, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1244300 | TX | |
| Physical Therapist | 225100000X | 62 037159 | NY | Primary |
Addresses
Primary practice location
4700 Taft Blvd
Apt 197
Wichita Falls, TX 76308-4802
Mailing address
4700 Taft Blvd
Apt 197
Wichita Falls, TX 76308-4802
Phone (940) 228-6825
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1244300 | Other | TX | PHYSICAL THERAPY LICENSE |
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 |
|---|---|---|---|
| 62 037159 | NY | MD | Physical Therapist |
| 1244300 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1700285970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 TAFT BLVD",
"address_2": "APT 197",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763084802",
"telephone_number": "940-228-6825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 TAFT BLVD",
"address_2": "APT 197",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763084802",
"telephone_number": "940-228-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHANUSHALI",
"first_name": "PRANAV",
"middle_name": "PURUSHOTTAMBHAI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-14",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1244300",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "62 037159",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "1244300",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.